Zhu Pei-hua, Huang Jing-yuan, Ye Meng, Zheng Zhe-lan
Department of Ultrasonography,Zhejiang Hospital,Hangzhou 310013,China.
Department of Ultrasonography, First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China.
Zhejiang Da Xue Xue Bao Yi Xue Ban. 2014 Sep;43(5):566-71. doi: 10.3785/j.issn.1008-9292.2014.09.003.
To evaluate the left ventricular twist characteristics in patients with type 2 diabetes by using two-dimensional speckle tracking imaging (STI).
Ninety-three patients with type 2 diabetes admitted in Zhejiang Hospital from May 2012 to September 2013 were enrolled. According to left ventricular ejection fraction (LVEF), patients were divided into two groups: normal left ventricular systolic function group (group A, LVEF≥0.50, n=46) and abnormal left ventricular systolic function group (group B, LVEF <0.50, n=47). Forty-six healthy subjects were selected as normal controls. STI was applied to quantitatively analyze the left ventricular twist. Correlation of the peak of left ventricular twist angle (Peaktw), aortic valve closure time twist angle (AVCtw), and mitral valve opening time twist angle (MVOtw) with LVEF, Tei index, E/A, and E/e was evaluated. Consistency check for STI was conducted to assess its stability and reliability.
The Peaktw, AVCtw, and MVOtw in group A were significantly elevated than those in normal controls (P<0.05). The Peaktw, AVCtw, and MVOtw in group B was lower than those in normal controls and group A (P<0.05). In diabetic patients, the Peaktw, AVCtw, MVOtw were positively correlated with LVEF (r=0.968, 0.966, 0.938;P<0.05) and E/A (r=0.798, 0.790, 0.788; P<0.05), and were negatively correlated with Tei index (r=-0.834, -0.811, -0.797; P<0.05) and E/e (r=-0.823, -0.805, -0.771; P<0.05). The agreement between measurers and within measurers of Peaktw was satisfactory (between measurers: R=0.957, bias=-0.1, 95% consistency limit=-2.8-2.7; within measurer: R=0.964, bias=-0.2, 95% consistency limits=-2.7-2.2).
STI can be used for early recognition of abnormal changes of cardiac function in type 2 diabetic mellitus patients, with high stability and reliability.
采用二维斑点追踪成像(STI)评估2型糖尿病患者的左心室扭转特征。
选取2012年5月至2013年9月在浙江医院收治的93例2型糖尿病患者。根据左心室射血分数(LVEF),将患者分为两组:左心室收缩功能正常组(A组,LVEF≥0.50,n = 46)和左心室收缩功能异常组(B组,LVEF < 0.50,n = 47)。选取46例健康受试者作为正常对照。应用STI定量分析左心室扭转情况。评估左心室扭转角度峰值(Peaktw)、主动脉瓣关闭时扭转角度(AVCtw)和二尖瓣开放时扭转角度(MVOtw)与LVEF、Tei指数、E/A及E/e的相关性。对STI进行一致性检验以评估其稳定性和可靠性。
A组的Peaktw、AVCtw和MVOtw显著高于正常对照组(P < 0.05)。B组的Peaktw、AVCtw和MVOtw低于正常对照组及A组(P < 0.05)。在糖尿病患者中,Peaktw、AVCtw、MVOtw与LVEF(r = 0.968、0.966、0.938;P < 0.05)及E/A(r = 0.798、0.790、0.788;P < 0.05)呈正相关,与Tei指数(r = -0.834、-0.811、-0.797;P < 0.05)及E/e(r = -0.823、-0.805、-0.771;P < 0.05)呈负相关。Peaktw测量者间及测量者内的一致性良好(测量者间:R = 0.957,偏差=-0.1,95%一致性界限=-2.8 - 2.7;测量者内:R = 0.964,偏差=-0.2,95%一致性界限=-2.7 - 2.2)。
STI可用于早期识别2型糖尿病患者心功能的异常变化,具有较高的稳定性和可靠性。