Department of Cardiology, Medical Academy, Lithuanian University of Health Sciences, Eivenių 2, 50028 Kaunas, Lithuania.
Medicina (Kaunas). 2012;48(1):31-8.
The aim of our study was to evaluate left ventricular (LV) longitudinal, radial, and rotational function and its relationship with conventional LV parameters of systolic and diastolic function in patients with aortic regurgitation (AR) by speckle-tracking echocardiography. MATERIAL AND METHODS. A total of 26 asymptomatic patients with moderate AR, 34 patients with severe AR, and 28 healthy controls were included into the study. LV rotation and longitudinal and radial strain were measured offline using speckle-tracking imaging. RESULTS. The systolic longitudinal strain (-18.3% [SD, 2.18%] vs. -21.0% [SD, 2.52%], P<0.05) and strain rate (-1.08 s(-1) [SD, 0.13 s(-1)] vs. -1.27 s(-1) [SD, 0.15 s(-1)], P<0.05) were significantly lower and apical rotation (11.3° [SD, 4.99°] vs. 8.30° [SD, 4.34°], P<0.05) as well as rotation rate (82.72°/s [SD, 28.24 °/s] vs. 71.00°/s [SD, 28.04 °/s], P<0.05) were significantly higher in the patients with moderate AR compared with the control patients. The LV systolic basal rotation, systolic radial strain, and diastolic radial strain rate were significantly reduced in the patients with severe AR compared with the control patients. The global longitudinal, radial strain, and LV systolic diameter were the independent predictors of LV ejection fraction in the patients with AR (R(2)=0.77). The LV systolic basal rotation in the control patients, diastolic longitudinal strain rate and systolic longitudinal strain in the patients with moderate and severe AR, respectively, were independent predictors of LV diastolic filling. CONCLUSIONS. LV long-axis dysfunction with an increased apical rotation was present in the patients with moderate AR, while LV radial function and systolic basal rotation were found to be reduced in more advanced disease. LV diastolic filling depended on diastolic and systolic LV strain and rotation components in the patients with AR.
我们的研究目的是通过斑点追踪超声心动图评估主动脉瓣反流（AR）患者的左心室（LV）纵向、径向和旋转功能及其与收缩和舒张功能的常规 LV 参数的关系。材料和方法。共纳入 26 例无症状中度 AR 患者、34 例重度 AR 患者和 28 例健康对照者。使用斑点追踪成像技术离线测量 LV 旋转和纵向及径向应变。结果。与对照组相比，中度 AR 患者的收缩期纵向应变（-18.3%[标准差，2.18%] vs. -21.0%[标准差，2.52%]，P<0.05）和应变率（-1.08 s(-1) [标准差，0.13 s(-1)] vs. -1.27 s(-1) [标准差，0.15 s(-1)]，P<0.05）显著降低，心尖旋转（11.3°[标准差，4.99°] vs. 8.30°[标准差，4.34°]，P<0.05）和旋转率（82.72°/s[标准差，28.24°/s] vs. 71.00°/s[标准差，28.04°/s]，P<0.05）显著增加。与对照组相比，重度 AR 患者的 LV 收缩期基底旋转、收缩期径向应变和舒张期径向应变率显著降低。AR 患者的整体纵向、径向应变和 LV 收缩末期直径是 LV 射血分数的独立预测因子（R(2)=0.77）。对照组患者的 LV 收缩期基底旋转、中度和重度 AR 患者的舒张期纵向应变率和收缩期纵向应变分别是 LV 舒张充盈的独立预测因子。结论。中度 AR 患者存在 LV 长轴功能障碍，心尖旋转增加，而更严重的疾病则发现 LV 径向功能和收缩期基底旋转降低。AR 患者的 LV 舒张充盈取决于舒张期和收缩期 LV 应变和旋转成分。
