Department of Ultrasound, The First Affiliated Hospital, Shihezi University, Shihezi, China.
School of Medicine, Shihezi University, Shihezi, China.
J Clin Ultrasound. 2023 Nov-Dec;51(9):1439-1448. doi: 10.1002/jcu.23568. Epub 2023 Oct 26.
To evaluate the early changes in left ventricular (LV) in patients with chronic obstructive pulmonary disease (COPD) by measuring tissue motion mitral annulus displacement (TMAD) and three-dimensional (3D) parameters using speckle tracking imaging (STI), and to explore its correlation with lung function.
Forty two COPD patients (GOLD I, GOLD II, GOLD III) and 30 healthy individuals (control group) were included. STI was used to assess the changes in LV structure and systolic function. Receiver operating characteristic (ROC) curves were drawn, and correlations among TMAD parameters, LV systolic function, structural, pulmonary artery systolic pressure (PASP), and lung function were analyzed.
Compared to the control group, COPD patients were able to undergo LV remodeling, with a decrease in the absolute value of global longitudinal strain (GLS) and TMAD, but no significant modification of LVEF. Correlation analysis showed that TMAD was positively related to the absolute value of GLS (r > 0.51, P < 0.01) and predicted forced expiratory volume in the first second (FEV1%) (r > 0.56, P < 0.01), and negatively to PASP (r < -0.52, P < 0.01). The LV posterior wall thickness (LVPWd), relative wall thickness (RWT), end-diastolic volume (LVEDV) and PASP negatively correlated with FEV1%.
The LV geometric changes and systolic function impairment in COPD patients were found to correlate with airflow restriction (FEV1%). TMAD aided in detection of early changes in LV systolic function in COPD patients. It negatively correlated with PASP and positively with FEV1%. Moreover, it was more convenient than GLS.
应用斑点追踪成像(STI)技术测量组织运动瓣环位移(TMAD)和三维(3D)参数,评估慢性阻塞性肺疾病(COPD)患者左心室(LV)的早期变化,并探讨其与肺功能的相关性。
纳入 42 例 COPD 患者(GOLD I、GOLD II、GOLD III)和 30 名健康对照者。应用 STI 评估 LV 结构和收缩功能的变化。绘制受试者工作特征(ROC)曲线,分析 TMAD 参数、LV 收缩功能、结构、肺动脉收缩压(PASP)和肺功能之间的相关性。
与对照组相比,COPD 患者存在 LV 重构,表现为整体纵向应变(GLS)绝对值和 TMAD 降低,但左心室射血分数(LVEF)无明显改变。相关性分析显示,TMAD 与 GLS 绝对值呈正相关(r>0.51,P<0.01),与第一秒用力呼气量(FEV1%)呈正相关(r>0.56,P<0.01),与 PASP 呈负相关(r<0.52,P<0.01)。LV 后壁厚度(LVPWd)、相对室壁厚度(RWT)、舒张末期容积(LVEDV)和 PASP 与 FEV1%呈负相关。
COPD 患者的 LV 几何变化和收缩功能障碍与气流受限(FEV1%)相关。TMAD 有助于检测 COPD 患者 LV 收缩功能的早期变化,与 PASP 呈负相关,与 FEV1%呈正相关,且比 GLS 更方便。