三维斑点追踪超声心动图评估高尿酸血症患者左心室功能的价值。
Value of three-dimensional speckle tracking echocardiography to assess left ventricular function in hyperuricemia patients.
机构信息
Department of Rheumatology, Zhongshan Hospital, Fudan University, Shanghai, China.
Department of Immunology, School of Basic Medical Sciences, Fudan University, Shanghai, 200032, China.
出版信息
Clin Rheumatol. 2018 Sep;37(9):2539-2545. doi: 10.1007/s10067-018-4132-0. Epub 2018 May 22.
To assess the value of three-dimensional speckle tracking echocardiography (3D STE) in evaluating the left ventricular (LV) function in hyperuricemia patients. We enrolled 15 healthy controls and 40 hyperuricemia patients and collected and analyzed full-volume 3D STE images of the left ventricle in the apical four-chamber heart view. Laboratory tests and 3D STE parameters, including left ventricular ejection fraction, left ventricular end-diastolic volume, left ventricular end-systolic volume, stroke volume (SV), global longitudinal strain (GLS), and global circumferential strain (GCS), were compared between hyperuricemia patients and healthy controls. Hyperuricemia patients exhibited higher body mass index (24.70 ± 2.9 vs. 21.83 ± 2.4 kg/m, p = 0.001), C-reactive protein (5.82 ± 9.4 vs. 1.12 ± 1.8 g/L, p = 0.012), alanine transaminase (34.26 ± 26.6 vs. 17.60 ± 13.0 U/L, p = 0.011), aspartate transaminase (24.90 ± 11.3 vs. 17.70 ± 4.1 U/L, p = 0.001), blood urea nitrogen (5.11 ± 1.6 vs. 4.18 ± 0.6 mmol/L, p = 0.046), and serum creatinine (90.25 ± 14.6 vs. 77.93 ± 10.8 μmol/L, p = 0.006) levels, as well as a lower estimated glomerular filtration rate (87.87 ± 16.5 vs. 103.64 ± 11.3 mL/min/1.73m, p = 0.002). The 3D STE parameters reflecting LV function, including SV (54.71 ± 9.6 vs. 61.92 ± 14.4 mL, p = 0.024), GLS (- 20.51 ± 4.0 vs. - 23.20 ± 4.0%, p = 0.019), and GCS (- 31.30 ± 5.0 vs. - 35.65 ± 2.5%, p = 0.000), were significantly decreased in hyperuricemia patients. Furthermore, GCS was significantly correlated with the serum uric acid (sUA) level even after adjustment of confounding variables like age, body mass index, and serum creatinine. 3D STE is a novel technique for recognizing the early decline in LV function, with GLS and GCS serving as reliable indicators, in hyperuricemia patients. Moreover, the degree of decline in LV function may be correlated with the sUA level in hyperuricemia patients.
目的 评估三维斑点追踪超声心动图（3D STE）在评估高尿酸血症患者左心室（LV）功能中的价值。我们纳入了 15 名健康对照者和 40 名高尿酸血症患者，并采集和分析了心尖四腔心观的左心室全容积 3D STE 图像。比较高尿酸血症患者和健康对照者的实验室检查和 3D STE 参数，包括左心室射血分数、左心室舒张末期容积、左心室收缩末期容积、每搏输出量（SV）、整体纵向应变（GLS）和整体圆周应变（GCS）。高尿酸血症患者的体重指数（24.70±2.9 比 21.83±2.4 kg/m，p=0.001）、C 反应蛋白（5.82±9.4 比 1.12±1.8 g/L，p=0.012）、丙氨酸转氨酶（34.26±26.6 比 17.60±13.0 U/L，p=0.011）、天门冬氨酸转氨酶（24.90±11.3 比 17.70±4.1 U/L，p=0.001）、血尿素氮（5.11±1.6 比 4.18±0.6 mmol/L，p=0.046）和血清肌酐（90.25±14.6 比 77.93±10.8 μmol/L，p=0.006）水平更高，估算肾小球滤过率（87.87±16.5 比 103.64±11.3 mL/min/1.73m，p=0.002）更低。反映 LV 功能的 3D STE 参数，包括 SV（54.71±9.6 比 61.92±14.4 mL，p=0.024）、GLS（-20.51±4.0 比-23.20±4.0%，p=0.019）和 GCS（-31.30±5.0 比-35.65±2.5%，p=0.000）在高尿酸血症患者中显著降低。此外，在调整年龄、体重指数和血清肌酐等混杂因素后，GCS 与血清尿酸（sUA）水平仍显著相关。3D STE 是一种识别高尿酸血症患者 LV 功能早期下降的新技术，GLS 和 GCS 是可靠的指标。此外，高尿酸血症患者 LV 功能下降程度可能与 sUA 水平相关。
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