Yao Qiyu, Zhang Yinglun, Wu Jun, Shu Hua, Ye Xinhua, Li Ao
Department of Ultrasound, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China.
Department of Geriatric Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China.
Front Cardiovasc Med. 2023 Mar 9;10:1132519. doi: 10.3389/fcvm.2023.1132519. eCollection 2023.
To assess the usefulness of gray-scale ultrasound (US) and shear wave elastography (SWE) in assessing the condition of the skeletal muscles in patients with chronic heart failure (CHF).
We prospectively compared 20 patients with clinically diagnosed CHF and a control population of 20 normal volunteers. The gastrocnemius medialis (GM) of each individual in the rest and the contraction position was assessed using gray-scale US and SWE. The quantitative US parameters including the fascicle length (FL), pinnation angle (PA), echo intensity (EI), and Young's modulus of the muscle were measured.
In the CHF group compared with the control group, in the rest position, there was a significant difference in EI, PA, and FL of the GM (< 0.001), but no statistically significant difference in Young's modulus values (> 0.05); however, in the contraction position, all parameters were statistically different between the two groups (< 0.001). In the different subgroups of the CHF group grouped according to New York Heart Association staging (NYHA) or left ventricular ejection fraction (LVEF), there were no significant differences in ultrasound parameters in the rest position. However, during the contraction of GM, the smaller the FL and Young's modulus, the larger the PA and EI with the increase of NYHA grade or the decrease of LVEF (< 0.001).
The gray-scale US and SWE can provide an objective assessment of skeletal muscle status for CHF patients and are expected to be used to guide their early rehabilitation training and improve their prognosis.
评估灰阶超声（US）和剪切波弹性成像（SWE）在评估慢性心力衰竭（CHF）患者骨骼肌状况中的作用。
我们前瞻性地比较了20例临床诊断为CHF的患者和20名正常志愿者组成的对照组。使用灰阶US和SWE评估每个个体在休息和收缩位置时的腓肠肌内侧头（GM）。测量了包括肌束长度（FL）、羽状角（PA）、回声强度（EI）和肌肉杨氏模量在内的定量US参数。
与对照组相比，CHF组在休息位置时，GM的EI、PA和FL存在显著差异（<0.001），但杨氏模量值无统计学显著差异（>0.05）；然而，在收缩位置时，两组之间所有参数均有统计学差异（<0.001）。在根据纽约心脏协会分级（NYHA）或左心室射血分数（LVEF）分组的CHF组不同亚组中，休息位置时超声参数无显著差异。然而，在GM收缩期间，随着NYHA分级增加或LVEF降低，FL和杨氏模量越小，PA和EI越大（<0.001）。
灰阶US和SWE可为CHF患者骨骼肌状态提供客观评估，有望用于指导其早期康复训练并改善预后。
