Yang Li, Qiu Qiong, Fang Si-hua
Department of Cardiology, Sun Yat-Sen Memorial Hospital, Sun Yet-Sen University, 107 Yanjiang West Road, Guangzhou, 510120, China,
Int J Cardiovasc Imaging. 2014 Dec;30(8):1465-71. doi: 10.1007/s10554-014-0485-x. Epub 2014 Jul 9.
To study left atrial deformation characteristics using Velocity vector imaging (VVI) in hypertensive patients with and without left ventricular hypertrophy (LVH), and to explore its value for detection of left atrial dysfunction in these patients. Sixty-four patients with essential hypertension were divided into normal left ventricular geometry (LVN, 37 cases) and LVH (27 cases) groups, according to their left ventricular mass index. Twenty-five age-matched healthy participants were included as control group. Two-dimensional dynamic images of the apical four- and two-chamber echocardiographic views were obtained, and strain/strain rate (SR) curves of eight atrial segments were derived by VVI software. Peak systolic strain (ε(sys)), systolic SR (SRs), early and late diastolic SR (SRe, SRa) were measured and calculated. Peak early diastolic mitral inflow and annulus velocities were also measured and their ratio (E/E') calculated. Compared with the control group, SRe decreased and SRa increased significantly in LVH group (P < 0.05), while no significant difference was found between LVN and control groups with respect to SRe, SRa, SRs and ε(sys) (P > 0.05). Also, no significant difference was observed in SRe, SRa, SRs and ε(sys) between LVH and LVN groups (P > 0.05). SRe and SRa correlated significantly with E/E' (r = -0.634, r = 0.609; both P < 0.001). Strain/SR parameters derived from VVI may reflect decreased conduit, increased booster pump function of the left atrium in hypertensive patients with LVH and correlate with left ventricular diastolic function.
采用速度向量成像（VVI）技术研究有或无左心室肥厚（LVH）的高血压患者左心房变形特征，并探讨其在检测这些患者左心房功能障碍中的价值。64例原发性高血压患者根据左心室质量指数分为正常左心室构型（LVN，37例）和LVH（27例）组。纳入25例年龄匹配的健康参与者作为对照组。获取心尖四腔和两腔超声心动图视图的二维动态图像，并通过VVI软件得出8个心房节段的应变/应变率（SR）曲线。测量并计算收缩期峰值应变（ε(sys)）、收缩期SR（SRs）、舒张早期和晚期SR（SRe、SRa）。还测量了舒张早期二尖瓣流入峰值速度和瓣环速度，并计算其比值（E/E'）。与对照组相比，LVH组SRe降低，SRa显著升高（P < 0.05），而LVN组与对照组在SRe、SRa、SRs和ε(sys)方面无显著差异（P > 0.05）。此外，LVH组与LVN组在SRe、SRa、SRs和ε(sys)方面也未观察到显著差异（P > 0.05）。SRe和SRa与E/E'显著相关（r = -0.634，r = 0.609；均P < 0.001）。VVI得出的应变/SR参数可能反映了有LVH的高血压患者左心房管道功能降低、增压泵功能增强，并与左心室舒张功能相关。
