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系统性硬化症中的斑点追踪超声心动图:检测心肌受累的一种有用方法。

Speckle tracking echocardiography in systemic sclerosis: A useful method for detection of myocardial involvement.

作者信息

Zairi I, Mzoughi K, Jnifene Z, Kamoun S, Jabeur M, Ben Moussa F, Kraiem S

机构信息

Department of cardiology, Habib Thameur Hospital, Bab el falah, 2004 Tunis, Tunisia.

Department of cardiology, Habib Thameur Hospital, Bab el falah, 2004 Tunis, Tunisia.

出版信息

Ann Cardiol Angeiol (Paris). 2019 Oct;68(4):226-231. doi: 10.1016/j.ancard.2018.08.027. Epub 2018 Oct 2.

Abstract

BACKGROUND

Systemic sclerosis is a multisystem disorder characterized by tissue fibrosis and organ damage. Heart involvement is one of the main factors shortening survival, which may be underestimated by conventional echocardiography measurements. Two-dimensional speckle-tracking echocardiography is a powerful novel modality to assess subclinical myocardial dysfunction.

AIM

The aim of this study is to investigate heart involvement in systemic sclerosis patients, and to determine the usefulness of ventricular longitudinal deformation using the Two-dimensional speckle tracking technology for an early detection of ventricular dysfunction.

PATIENTS AND METHODS

Between May 2016 and September 2016, 25 patients with systemic sclerosis and 25 healthy subjects underwent echocardiography to assess heart abnormalities and the strain of the two ventricles using two dimensions' speckle tracking echography.

RESULTS

The two groups were comparable in age and gender. Despite comparable left ventricle systolic function (left ventricular ejection fraction patients 64.58±8.87 vs. in healthy 68.2±7.41, P=0.19), patients presented altered longitudinal peak systolic strain values (global longitudinal strain: patients -17.42±1.62 vs. healthy -19.24±8.85, P<0.0001). Despite comparable pulmonary artery systolic pressure, there was a significant alteration in right ventricular systolic and diastolic function assessed by standard measurement. Longitudinal peak systolic strain of the right ventricle was significantly lower in patients compared with controls (P<0.01).

CONCLUSION

Ventricular deformation analysis by two dimensions' speckle tracking echocardiography appears to be a sensitive method to detect early ventricular impairment in patients with systemic sclerosis.

摘要

背景

系统性硬化症是一种以组织纤维化和器官损害为特征的多系统疾病。心脏受累是缩短生存期的主要因素之一,而传统超声心动图测量可能会低估这一情况。二维斑点追踪超声心动图是评估亚临床心肌功能障碍的一种强大的新型方法。

目的

本研究旨在调查系统性硬化症患者的心脏受累情况,并确定使用二维斑点追踪技术进行心室纵向变形分析对早期检测心室功能障碍的实用性。

患者和方法

2016年5月至2016年9月期间,25例系统性硬化症患者和25名健康受试者接受了超声心动图检查,以使用二维斑点追踪超声心动图评估心脏异常情况和两个心室的应变。

结果

两组在年龄和性别方面具有可比性。尽管左心室收缩功能相当(患者左心室射血分数为64.58±8.87,健康人为68.2±7.41,P = 0.19),但患者的纵向收缩期峰值应变值发生了改变(整体纵向应变:患者为-17.42±1.62,健康人为-19.24±8.85,P<0.0001)。尽管肺动脉收缩压相当,但通过标准测量评估的右心室收缩和舒张功能存在显著改变。患者右心室的纵向收缩期峰值应变明显低于对照组(P<0.01)。

结论

二维斑点追踪超声心动图进行的心室变形分析似乎是检测系统性硬化症患者早期心室损害的一种敏感方法。

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