Department of Cardiology, CHU de Caen, Caen, France.
J Am Soc Echocardiogr. 2011 Sep;24(9):1037-45. doi: 10.1016/j.echo.2011.06.004. Epub 2011 Jul 18.
The aim of this work was to evaluate myocardial strain analysis as a tool for the early detection of left ventricular functional changes in patients with cystic fibrosis.
A total of 42 consecutive patients (mean age, 24 ± 7.5 years; 52% men) diagnosed with cystic fibrosis and referred for echocardiographic cardiac function assessment were prospectively enrolled. A group of healthy age-matched and gender-matched volunteers (n = 42) formed the reference population for echocardiographic comparisons.
Left ventricular ejection fraction was conserved in both groups but was significantly lower in the cystic fibrosis group. Cardiac function assessment using Doppler tissue imaging parameters revealed that both systolic and diastolic measurements differed between the two groups: mitral peak systolic and diastolic velocities, as well as septal and lateral wall strain rates, were decreased in patients with cystic fibrosis, as was longitudinal strain of both the septal and lateral walls.
Using strain measurements, subclinical changes in left ventricular function were found in patients with cystic fibrosis. These parameters were correlated with the degree of pulmonary involvement severity. These findings have potentially significant clinical implications for the outcomes and follow-up of patients with cystic fibrosis, meriting further studies.
本研究旨在评估心肌应变分析作为一种早期检测囊性纤维化患者左心室功能变化的工具。
共纳入 42 例连续就诊的囊性纤维化患者（平均年龄 24 ± 7.5 岁，52%为男性），并进行超声心动图心功能评估。年龄和性别匹配的健康志愿者（n=42）为超声心动图比较的参考人群。
两组患者的左心室射血分数均保持正常，但囊性纤维化组的射血分数明显降低。使用多普勒组织成像参数进行的心脏功能评估显示，两组之间存在收缩期和舒张期的测量差异：囊性纤维化患者的二尖瓣收缩期和舒张期峰值速度、室间隔和侧壁应变率均降低，室间隔和侧壁的纵向应变也降低。
使用应变测量发现囊性纤维化患者存在左心室功能的亚临床变化。这些参数与肺部受累严重程度相关。这些发现对囊性纤维化患者的预后和随访具有重要的临床意义，值得进一步研究。
