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目的:探讨采用斑点追踪成像(STI)技术测定左室心内膜层和心外膜层心肌收缩期峰值应变评价原发性高血压(EH)左室不同构型患者左室收缩功能的价值。方法:入选EH患者56例(EH组),其中非左室肥厚30例(A亚组),左室肥厚26例(B亚组);健康志愿者53例(对照组)。应用STI技术获取所有对象左室长轴及短轴各切面的心内、外膜层心肌收缩期纵向、径向峰值应变及左室心内、外膜层心肌的整体纵向和径向峰值应变值。结果:B亚组患者左室心内、外膜层心肌收缩期纵向峰值应变显著低于对照组(心内膜层:P<0.01;心外膜层:P<0.05),EH组二尖瓣水平短轴径向峰值应变显著高于对照组(P<0.05)。结论:EH患者径向应变的增高代偿了纵向应变的减低,STI可评价EH不同构型患者左室整体和局部收缩功能从而为早期发现心肌病变提供了无创性的新方法。
Objective: To investigate the value of left ventricular systolic function in patients with left ventricular hypertrophy assessed by peak tracking of left ventricular endocardial and epicardial myocardium using speckle tracking imaging (STI). Methods: EH patients were enrolled in 56 cases (EH group), including non-LV hypertrophy in 30 cases (A subgroup), left ventricular hypertrophy in 26 cases (B subgroup) and healthy volunteers in 53 cases (control group). STI technique was used to obtain the longitudinal and radial peak strain of myocardial and epicardial myocardial systolic and longitudinal and radial peak strain values of left and right ventricular endocardium in all subjects . Results: Longitudinal peak systolic strain of left ventricular endocardium and epicardium in group B was significantly lower than that in control group (endocardial layer: P <0.01; epicardial layer: P <0.05), mitral valve The horizontal short-axis radial peak strain was significantly higher than that of the control group (P <0.05). Conclusion: The increase of radial strain in EH patients compensates for the reduction of longitudinal strain. STI can evaluate left ventricular global and regional systolic function in patients with different EH configurations and thus provide a new noninvasive method for the early detection of myocardial lesions.