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目的:应用速度向量成像技术观察慢性心力衰竭(CHF)患者左心室短轴径向各节段心肌应变和应变率变化,评价左室收缩功能及心功能。方法:选取宁夏医科大学总院心脑血管病医院心血管内科2014-10-2015-05收治的CHF患者100例(心衰组),根据NYHA心脏功能分级分组:NYHAⅡ级组35例、Ⅲ级组32例、Ⅳ级组33例。选择同期30例体检健康者为正常对照。ELISA法测得血清BNP水平,采用超声心动图常规测量左室射血分数(LVEF)、左室收缩末期内径(LVDS)、左室舒张末期内径(LVDD)及左室短轴缩短率(LVFS),选择VVI模式,测量左室胸骨旁短轴切面前壁、侧壁、后壁、下壁、后间隔及前间隔的应变和应变率。结果:心衰组各节段ε、SRs显著低于对照组,除二尖瓣水平前间隔ε、乳头肌水平侧壁、后壁SRs外,差异均有统计学意义(均P<0.05)。NYHAⅡ~Ⅳ级组各节段ε、SRs基本呈下降趋势,与正常对照组相比差异有统计学意义(P<0.05)。NYHA分级Ⅱ级与Ⅲ级、Ⅲ级与Ⅳ级比较差异无统计学意义。整体平均ε、SRs与LVEF、LVFS呈负相关,与LVDd、LVDs、BNP呈正相关。结论:VVI可用于定量检测左心室局部和整体的应变和应变率,为评价心功能和诊断CHF提供新的方法。
OBJECTIVE: To evaluate the changes of left ventricular systolic and cardiac function in patients with chronic heart failure (CHF) by means of velocity vector imaging. Methods: 100 cases of CHF patients (heart failure group) admitted to the Hospital of Cardiovascular Diseases Hospital of Ningxia Medical University from October 2014 to May 2015 were divided into three groups: NYHA Ⅱ group (n = 35), grade Ⅲ 32 cases, group Ⅳ in 33 cases. Select the same period 30 cases of healthy people as a normal control. Serum BNP levels were measured by ELISA. Left ventricular ejection fraction (LVEF), left ventricular end-systolic diameter (LVDS), left ventricular end-diastolic diameter (LVDD) and left ventricular fractional shortening (LVFS) were measured by echocardiography. , VVI mode was selected to measure the strain and strain rate of the anterior, lateral, posterior wall, inferior wall, posterior septum and anterior septal of left parasternal short axis view. Results: The ε, SRs in each segment of heart failure group were significantly lower than those in control group, except for the mitral valve clearance ε, the level of the papillary muscle and the posterior wall SRs (all P <0.05). The levels of ε and SRs in NYHA Ⅱ ~ Ⅳ group decreased gradually, which were significantly different from the normal control group (P <0.05). NYHA grade Ⅱ and Ⅲ grade, Ⅲ and Ⅳ grade difference was not statistically significant. The overall mean ε, SRs were negatively correlated with LVEF and LVFS, and positively correlated with LVDd, LVDs and BNP. Conclusion: VVI can be used to quantitatively measure the local and global left ventricular strain and strain rate, providing a new method for the evaluation of cardiac function and diagnosis of CHF.