| 刘淼,傅晓红,陈鸣,等.斑点追踪对射血分数保留型心力衰竭早期识别的应用价值[J].安徽医药,2026,30(8):1610-1615. |
| 斑点追踪对射血分数保留型心力衰竭早期识别的应用价值 |
| Application of speckle tracking imaging in identifying early-stage heart failure with preserved ejection fraction |
| |
| DOI：10.3969/j.issn.1009-6469.2026.08.025 |
| 中文关键词: 射血分数正常的心力衰竭 斑点追踪 超声心动图 左室整体纵向应变 左房储存期应变 |
| 英文关键词: Heart failure with normal ejection fraction Speckle tracking imaging Echocardiography Left ventricular global lon-gitudinal strain Left atrial reservoir strain |
| 基金项目:上海市浦东新区卫生健康委员会科研项目( PW2023A-08) |
| 作者 | 单位 | E-mail | | 刘淼 | 上海市浦东新区公利医院,超声医学科,上海 200135 | | | 傅晓红 | 上海市浦东新区公利医院,超声医学科,上海 200135 | | | 陈鸣 | 上海市浦东新区公利医院,超声医学科,上海 200135 | | | 王君 | 上海市浦东新区公利医院,超声医学科,上海 200135 | | | 贾照英 | 上海市浦东新区公利医院,心内科,上海 200135 | | | 徐茂椿 | 上海市浦东新区公利医院,心内科,上海 200135 | maochun_xu@sina.com |
|
| 摘要点击次数: 97 |
| 全文下载次数: 22 |
| 中文摘要: |
| 目的运用斑点追踪技术评估对射血分数保留型心力衰竭( HFpEF)病人早期识别的应用价值。方法回顾性收集 2023年 1月至 2025年 3月上海市浦东新区公利医院收治的符合 HFpEF诊断的病人 39例( HFpEF组)、左心室舒张功能障碍但不伴有心力衰竭( LVDD)的病人 39例( LVDD组)及同期门诊正常体检人群 39例(健康对照组)。行超声心动图检查，采集心尖四腔、三腔及两腔观察连续 3个心动周期，将超声获取的图像导入 TomTec工作站进行二维斑点追踪技术( STI)数据分析，获得左心室整体纵向应变(LV-GLS)、左房三期［左房储存期应变( LASr)、左房管道期应变( LAScd)及左房收缩期应变(LASct)］参数及左房应变衍生参数左房僵硬指数( LASI)及左房充盈指数，分析三组间各参数差异。结果三组 LV-GLS、LASr、LAScd、LAS-ct、LASI及左房充盈指数均差异有统计学意义( P<0.05)。 HFpEF组 LV-GLS(.13.35±3.96)%、LASr(17.07±7.63)%、LAScd(.9.19±3.45)%、LASct(.7.89±5.30)%均低于健康对照组［( .22.63±2.23)%、(47.17±11.22)%、(.26.44±11.52)%、(.20.73±7.07)%］和 LVDD组［( .21.2±2.89)%、(30.57±11.18)%、(.15.66±7.23)%、(.14.92±7.14)%］(P<0.05)。 HFpEF组 LASI 1.22±1.10、左房充盈指数 7.31±4.70均高于健康对照组(0.18±0.09、1.73±0.58)和 LVDD组( 0.58±0.57、3.53±3.41)(P<0.05)。受试者操作特征曲线( ROC曲线)显示，在 LVDD组中预测 HFpEF时 LV-GLS曲线下面积( AUC)相对较大为 0.94，截断值 .19.3%；在健康对照组中预测 HFpEF时 LV-GLS、LASr、LAScd、LASct、LASI及左房充盈指数 AUC均较大， AUC分别为 0.99、0.98、0.93、0.93、0.99及 0.97，截断值分别为 .19.85%、33.35%、.15.15%、.14.15%、0.46及 3.12。左室左房应变参数与脑利尿钠肽( BNP)相关性分析， LV-GLS、LASr、LAScd及 LASct与 BNP呈负相关， LASI及左房充盈指数与 BNP呈正相关。结论 LV-GLS、LASr、LAScd、 LASct、LASI及左房充盈指数应变参数在左室舒张功能减退人群中和正常人群中预测 HFpEF诊断效能良好，能无创定量评估 HFpEF左室及左房功能，对于 HFpEF早期识别具有一定作用。 |
| 英文摘要: |
| Objective To evaluate the clinical value of Speckle Tracking Imaging (STI) in early identification of heart failure withpreserved ejection fraction (HFpEF).Methods The study enrolled patients admitted to Gongli Hospital in Pudong New Area, Shang-hai, from January 2023 to March 2025. A retrospective collection of 39 patients who met the diagnosis criteria for HFpEF (HFpEFgroup), 39 patients with left ventricular diastolic dysfunction but without heart failure (LVDD group), and 39 healthy control subjectswho underwent outpatient physical examinations during the same period were included in the study. Echocardiographic images of threeconsecutive cardiac cycles were collected from standardized apical four-chamber, three-chamber, and two-chamber views. Import ultra-sound acquired images into TomTec workstation for two-dimensional speckle tracking (STI) data analysis, left ventricular global longitu-dinal strain (LV-GLS), left atrial strain parameters during three phases (reservoir phase LASr, conduit phase LAScd, and contractilephase LASct), and derived left atrial parameters including left atrial stiffness index (LASI) and left atrial filling index (LA filling index)were obtained. Analyze the differences in each parameter among the three groups.Results There were statistically significant differ-ences in LV-GLS, LASr, LAScd, LASct, LASI, and left atrial filling index among the three groups (P<0.05). The LV-GLS (.13.35 ±3.96)%, LASr (17.07 ± 7.63)%, LAScd (.9.19 ± 3.45)%, and LASct (.7.89 ± 5.30)% in the HFpEF group were all lower than those inthe healthy control group [(.22.63 ± 2.23)%, (47.17 ± 11.22)%, (.26.44 ± 11.52)%, (.20.73 ± 7.07)%] and LVDD group [(.21.2 ±2.89)%, (30.57 ± 11.18)%, (.15.66 ± 7.23)%, (.14.92 ± 7.14)%] (P<0.05). The LASI (1.22 ± 1.10) and left atrial filling index (7.31 ± 4.70) in the HFpEF group were higher than those in the healthy control group (0.18 ± 0.09, 1.73 ± 0.58) and LVDD group (0.58 ± 0.57,3.53 ± 3.41) (P<0.05). Receiver operating characteristic curve (ROC curve) analysis revealed that, in the LVDD group, LV-GLS had the largest area under the curve (AUC) for predicting HFpEF (AUC=0.94, cutoff value .19.3%. In the normal control group, the AUCs forpredicting HFpEF were higher for LV-GLS, LASr, LAScd, LASct, LASI, and LA filling index, with values of 0.99, 0.98, 0.93, 0.93,0.99, and 0.97, respectively; corresponding cutoff values were .19.85%, 33.35%, .15.15%,.14.15%, 0.46, and 3.12. Correlation analy-sis between left ventricular and left atrial strain parameters and BNP showed that LV-GLS, LASr, LAScd, and LASct were negativelycorrelated with BNP, while LASI and LA filling index were positively correlated with BNP.Conclusions The strain parameters LV-GLS, LASr, LAScd, LASct, LASI, and LA filling index demonstrate good diagnostic efficacy in predicting HFpEF in both populationswith left ventricular diastolic dysfunction and normal controls. These parameters enable non-invasive quantitative assessment of leftventricular and left atrial function in HFpEF, offering a valuable role in the early identification of HFpEF. |
|
查看全文
查看/发表评论 下载PDF阅读器 |
| 关闭 |
|
|
|
