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应用无创压力-应变环技术评估原发性高血压患者左心室心肌做功。

Assessment of left ventricular myocardial work done by noninvasive pressure-strain loop technique in patients with essential hypertension.

机构信息

Department of Ultrasound, Taixing People's Hospital, Taixing, China.

Department of Ultrasound, Medical Imaging Center, Affiliated Hospital of Yangzhou University, Yangzhou, China.

出版信息

Ann Noninvasive Electrocardiol. 2022 Nov;27(6):e12983. doi: 10.1111/anec.12983. Epub 2022 Jun 23.

Abstract

OBJECTIVE

To investigate the value of the noninvasive pressure-strain loop (PSL) technique for assessing left ventricular myocardial work done in patients with essential hypertension.

METHODS

Prospectively, 60 patients with hypertension visiting the hospital from August 2020 to July 2021 were collected and divided into the mild hypertension group (SBP 140-159 mmHg, 35 cases) and the moderate-to-severe hypertension group (SBP ≥160 mmHg, 25 cases). Another 40 cases of healthy adults were collected as the control group. The differences in the global long-axis strain (GLS) and peak strain dispersion (PSD) of the left ventricle, global work index (GWI), global constructive work (GCW), global wasted work (GWW), and global work efficiency (GWE) were compared among the three groups. The receiver operating characteristic curve was used to evaluate the PSD, GWI, GCW, and GWW. The myocardial work index (MWI) and MWI percentages in the apical, middle, and basal segments of the heart were also compared among the groups.

RESULTS

(1) The PSD, GWI, GCW, and GWW were significantly different among the groups (Χ  = 57.605, 79.203, 76.973, and 17.429, respectively, p < .05), while the GLS and GWE were not (Χ  = 1.559 and 5.849, respectively, p > .05). (2) The GWI had the highest specificity (97.5%) and the GCW the highest sensitivity (95%) in predicting hypertension. The percentage of apical MWI gradually increased (F = 11.230, p < .05) and the percentage of basal MWI gradually decreased (F = 10.665, p < .05) from the control group to the mild hypertension group to the moderate-to-severe hypertension group; there was no significant difference in the percentage of mid-MWI (F = 0.593, p > .05).

CONCLUSIONS

The noninvasive PSL technique could be used to assess myocardial work done in patients with essential hypertension.

摘要

目的

探讨无创压力-应变环(PSL)技术评估原发性高血压患者左心室心肌做功的价值。

方法

前瞻性收集 2020 年 8 月至 2021 年 7 月期间就诊的 60 例高血压患者,根据血压水平分为轻度高血压组(SBP 140-159mmHg,35 例)和中重度高血压组(SBP≥160mmHg,25 例)。另收集 40 例健康成年人作为对照组。比较三组间左心室整体长轴应变(GLS)及峰值应变离散度(PSD)、整体做功指数(GWI)、整体构造成功率(GCW)、整体无效功(GWW)和整体做功效率(GWE)的差异。采用受试者工作特征曲线(ROC)评估 PSD、GWI、GCW 和 GWW。比较三组间心尖、中段和基底节段心肌做功指数(MWI)及 MWI 百分比。

结果

(1)三组间 PSD、GWI、GCW 和 GWW 差异均有统计学意义(Χ²分别为 57.605、79.203、76.973 和 17.429,均 P<0.05),而 GLS 和 GWE 差异无统计学意义(Χ²分别为 1.559 和 5.849,均 P>0.05)。(2)GWI 预测高血压的特异性最高(97.5%),GCW 敏感性最高(95%)。MWI 百分比自对照组至轻度高血压组至中重度高血压组逐渐升高(F=11.230,P<0.05),而基底节段 MWI 百分比逐渐降低(F=10.665,P<0.05);中节段 MWI 百分比差异无统计学意义(F=0.593,P>0.05)。

结论

无创 PSL 技术可用于评估原发性高血压患者的心肌做功。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f1fe/9674785/fa78108ca444/ANEC-27-e12983-g001.jpg

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