Wang Bin, Chen Haiyan, Shu Xianhong, Hong Tao, Lai Hao, Wang Chunsheng, Cheng Leilei
Department of Cardiac Surgery, Zhongshan Hospital, Fudan University, Shanghai Institute of Cardiovascular Diseases, Shanghai, China.
Interact Cardiovasc Thorac Surg. 2013 Aug;17(2):384-91. doi: 10.1093/icvts/ivt171. Epub 2013 May 3.
Systolic function of the left ventricle is vital for patients with aortic stenosis. Unfortunately, the most widely used clinical parameter, the left ventricular ejection fraction, is not sensitive enough, especially for patients with left ventricular hypertrophy. Echocardiographic strain/strain rate and twist are emerging parameters for left ventricular systolic and diastolic function evaluation. Aortic stenosis could reduce strain/strain rate while magnifying twist. Furthermore, strain/strain rate correlates well with the prognosis of patients with aortic stenosis. Most importantly the circumferential strain, strain rate and twist also play a role in differentiating cardiac compensation or decompensation. In any case, these parameters could normalize after successful surgical aortic valve replacement or transcatheter aortic valve replacement. Regardless of these advantages, clinical evidence is needed to ensure their usefulness.
左心室的收缩功能对主动脉瓣狭窄患者至关重要。不幸的是，临床最常用的参数——左心室射血分数不够敏感，尤其是对于左心室肥厚的患者。超声心动图应变/应变率和扭转是评估左心室收缩和舒张功能的新兴参数。主动脉瓣狭窄可降低应变/应变率，同时增大扭转。此外，应变/应变率与主动脉瓣狭窄患者的预后密切相关。最重要的是，圆周应变、应变率和扭转在区分心脏代偿或失代偿方面也起作用。无论如何，这些参数在成功进行外科主动脉瓣置换术或经导管主动脉瓣置换术后可恢复正常。尽管有这些优点，但仍需要临床证据来确保它们的实用性。
