【作者】 韩舒；

【导师】 杨军；

【作者基本信息】 中国医科大学 ， 影像医学与核医学， 2010， 硕士

【摘要】 目的本研究应用超声斑点追踪显像探讨原发性高血压对左室扭转与解旋运动的影响,并进一步探索不同程度左室心肌肥厚(LVH)对扭转与解旋的影响。方法45例按照LVH程度分为三组的原发性高血压患者与20例正常人经胸采集4个心动周期标准左室短轴基底及心尖平面二维图像并存储,运用Echo PAC超声工作站进行脱机分析,获得以上两平面旋转角度-时间、旋转速度-时间曲线以及左室整体的扭转角度-时间、扭转速度-时间曲线。结果1、原发性高血压组与正常组相比舒张早期解旋程度与解旋率均显著减低(P<0.01),并且均与左室质量指数的增加相平行,标化达解旋峰速时间显著延迟(P<0.01),解旋速度峰值增大(P<0.05)。2、原发性高血压组收缩期峰值扭转增强,但在不同程度的LVH患者中无统计学差异(P>0.05)。高血压组与正常组的左室扭转角度-时间、扭转速度-时间曲线走行趋势基本一致。3、舒张早期左室解旋程度、解旋率、标化达解旋速度峰值时间与传统评价左室舒张功能参数相比可更敏感反映左室舒张早期舒张功能变化。结论原发性高血压患者左室舒张功能减低可能与舒张早期左室解旋减小及延迟有关。STI技术可作为无创性定量评价左室舒张功能的新工具。更多还原

【Abstract】 ObjectiveTo assess the left ventricular (LV) twist and untwist changes in patients with primary hypertension using speckle tracking imaging (STI) echocardiography, also to assess the LV twist and untwist changes in patients with different degrees of left ventricular hypertrophy (LVH) furtherly.Methods45 primary hypertension patiens groupeded into 3 groups accroding to different degrees of LVH were included and 20 healthy subjects were on control group. Clear two-dimensional images of the left ventricular short axis views at basal and apical levels were recorded in 4 continuous cardiac cycles. The images were analyzed by 2D-speckle tracking soft in Echo PAC workstation, we acquired rotation angle-time and rotation velocity-time curves of the above two planes and global LV twist angle-time and twist velocity-time curves.Results1. Untwisting early in diastole and untwisting rate were significantly reduced in parallel to increasing left ventricular mass index (LVMI) (P<0.01). The duration of normalized time-to-peak untwisting velocity (TPUV) was significantly prolonged (P< 0.01) and peak untwisting velocity (PUV) increased (P<0.05).2. The peak systolic twist increased in hypertensive patients, but no inter-group differences were noted among patients with different degrees of LVH (P>0.05).The LV twist angle-time and twist velocity-time curves in hypertensive patients performs a similar courser tendency with healthy subjects.3. The novel diastolic parameters derivatized from STI (including untwisting or untwisting rates during early diastole, standardized TPUV) were more sensitive than traditional diastolic parameters in reflexing changes of LV relaxation fuction during early diastole.ConclusionsnsThe reduced and delayed diastolic untwisting during the isovolumic relaxation period noted in essential hypertensive patients may contribute to the LV relaxation reduced. Speckle tracking imaging echocardiography is a novel tool which can be used for the non-invasive and quantitateive assessment of LV relaxation.更多还原