Wang Qin, Sun Qi-Wei, Wu Dan, Yang Ming-Wu, Li Rong-Juan, Jiang Bo, Yang Jiao, Li Zhi-An, Wang Ying, Yang Ya
Department of Echocardiography, Beijing Anzhen Hospital, Capital Medical University and Beijing Institute of Heart Lung and Blood Vessel Diseases, The Key Laboratory of Remodeling Related Cardiovascular Diseases, Ministry of Education, Beijing 100029, China.
Chin Med J (Engl). 2015 Jan 20;128(2):226-32. doi: 10.4103/0366-6999.149211.
Strain and strain-rate imaging (SRI) have been found clinically useful in the assessment of cardiac systolic and diastolic function as well as providing new insights in deciphering cardiac physiology and mechanics in cardiomyopathies, and identifying early subclinical changes in various pathologies. The aim of this study was to evaluate the regional and global left ventricular (LV) myocardial function in metabolic syndrome (MS) with SRI so that we can provide more myocardial small lesions in patients with MS, which is robust and reliable basis for early detection of LV function.
Thirty-nine adults with MS were enrolled in the study. There was a control group of 39 healthy adults. In addition to classic echocardiographic assessment of LV global functional changes, SRI was used to evaluate regional and global LV function. Including: Peak systolic strain (S), peak systolic strain-rate (SR-s), peak diastolic strain-rate (SR-e).
There were no statistically significant differences between MS and controls in all traditional parameters of LV systolic function. On the other hand, significant differences were observed between MS and the control group in most of the parameters of S, SR-s, SR-e in regional LV function. Multiple stepwise regression analyses revealed that S and SR significantly were negatively correlated with blood pressure, waist circumference, fasting plasma glucose, uric acid, suggesting that risk factories were relevant to regional systolic dysfunction.
In MS with normal LV ejection fraction, there was regional myocardial dysfunction, risk factors contributed to the impairment of systolic and diastolic function of the regional myocardium. Assessment of myocardial function using SRI could be more accurate in MS patient evaluation than conventional echocardiography alone.
应变及应变率成像(SRI)在评估心脏收缩和舒张功能方面已被证明具有临床实用性,同时在解读心肌病的心脏生理和力学以及识别各种病理状态下的早期亚临床变化方面也提供了新的见解。本研究的目的是利用SRI评估代谢综合征(MS)患者左心室(LV)的局部和整体心肌功能,以便为MS患者提供更多心肌微小病变信息,这是早期检测左心室功能的有力且可靠的依据。
39名成年MS患者参与了本研究。另有39名健康成年人作为对照组。除了对左心室整体功能变化进行经典的超声心动图评估外,还使用SRI评估左心室的局部和整体功能。包括:收缩期峰值应变(S)、收缩期峰值应变率(SR-s)、舒张期峰值应变率(SR-e)。
在左心室收缩功能的所有传统参数方面,MS患者与对照组之间无统计学显著差异。另一方面,在左心室局部功能的大多数S、SR-s、SR-e参数方面,MS患者与对照组之间观察到显著差异。多元逐步回归分析显示,S和SR与血压、腰围、空腹血糖、尿酸显著负相关,提示危险因素与局部收缩功能障碍相关。
在左心室射血分数正常的MS患者中,存在局部心肌功能障碍,危险因素导致局部心肌收缩和舒张功能受损。在评估MS患者时,使用SRI评估心肌功能可能比单纯的传统超声心动图更准确。