Yang C G, Ma C S, Fan L, Su B, Wang Y X, Jiang G D, Zhou B Y
Department of Cardiovascular Medicine, the First Affiliated Hospital of Soochow University, Suzhou 215006, China (Yang Changgen is working on the Department of Critical Care Medicine, Zhejiang Provincial People's Hospital, Hangzhou 310012, China).
Department of Cardiovascular Medicine, the First Affiliated Hospital of Soochow University, Suzhou 215006, China.
Zhonghua Yi Xue Za Zhi. 2020 Nov 24;100(43):3431-3436. doi: 10.3760/cma.j.cn112137-20200423-01282.
To investigate the characteristics of left ventricular longitudinal strain (LS) in myocardial amyloidosis (CA), hypertrophic cardiomyopathy (HCM) and Fabry disease (FD), as well as the correlation between left ventricular LS and these diseases. A total of 14 CA patients, 28 HCM patients and 5 FD patients who visited the Department of Cardiology of the First Affiliated Hospital of Suzhou University from June 2017 to November 2019 were retrospectively included. EchoPAC software was used to analyze left ventricular LS, and univariate logistic regression analysis was used to analyze the correlation between echocardiographic LS indexes and various myocardial hypertrophy diseases. The receiver operating characteristic (ROC) curve was used to assess the sensitivity and specificity of echocardiograph LS indexes in the diagnosis of various myocardial hypertrophy diseases. There were significant differences in LS of left ventricular basal segment, inferior wall, posterior wall, lateral wall and posterior septum among the three groups (<0.05). The absolute value of LS in the left ventricular basal segment decreased in the CA group; the absolute value of LS in left ventricular posterior wall and lateral wall decreased significantly in the FD group (<0.05); the absolute values of LS in left ventricular basal segment, inferior wall, posterior septum, lateral wall and posterior wall increased significantly in the HCM group (<0.05). The absolute value of LS < 7.9% in the left ventricular basal segment, or > 13.2% in the inferior wall and > 9.2% in the basal segment, or < 8.3% in the lateral wall and < 7.9% in the posterior wall were the indicators of high sensitivity and specificity in the diagnosis of CA, HCM and FD, respectively. Left ventricular LS was an important index to differentiate myocardial hypertrophy. Combined with their respective clinical characteristics, it could provide certain reference value for clinical practice.
为研究心肌淀粉样变性（CA）、肥厚型心肌病（HCM）和法布里病（FD）患者左心室纵向应变（LS）的特征，以及左心室LS与这些疾病之间的相关性。回顾性纳入2017年6月至2019年11月在苏州大学附属第一医院心内科就诊的14例CA患者、28例HCM患者和5例FD患者。采用EchoPAC软件分析左心室LS，并采用单因素logistic回归分析超声心动图LS指标与各种心肌肥厚疾病之间的相关性。采用受试者操作特征（ROC）曲线评估超声心动图LS指标对各种心肌肥厚疾病诊断的敏感性和特异性。三组患者左心室基底段、下壁、后壁、侧壁和后间隔的LS差异有统计学意义（<0.05）。CA组左心室基底段LS绝对值降低；FD组左心室后壁和侧壁LS绝对值显著降低（<0.05）；HCM组左心室基底段、下壁、后间隔、侧壁和后壁LS绝对值显著升高（<0.05）。左心室基底段LS绝对值<7.9%，或下壁>13.2%、基底段>9.2%，或侧壁<8.3%、后壁<7.9%分别是诊断CA、HCM和FD的高敏感性和特异性指标。左心室LS是鉴别心肌肥厚的重要指标。结合各自的临床特征，可为临床实践提供一定的参考价值。
