Wang Yu-Lin, Yin Li-Xue, Li Mei
Ultrasound in Cardiac Electrophysiology and Biomechanics Key Laboratory of Sichuan Province, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, 610072, China.
Department of Gynaecology and Obstetrics, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China.
Echo Res Pract. 2024 Sep 2;11(1):20. doi: 10.1186/s44156-024-00056-x.
Due to the lack of oestrogen, premature ovarian insufficiency (POI) is an independent risk factor for ischaemic heart disease and overall cardiovascular disease. This study aimed to apply layer-specific myocardial strain for early quantitative evaluation of subclinical left ventricular myocardial systolic function changes in patients with POI.
Forty-eight newly diagnosed, untreated patients with POI (POI group) and fifty healthy female subjects matched for age, height and weight (control group) were enrolled. Standard transthoracic echocardiography was used to measure conventional parameters and layer-specific strain parameters.The layer-specific strain parameters included subendomyocardial global longitudinal strain (GLSendo), mid-layer myocardial global longitudinal strain (GLSmid), subepimyocardial global longitudinal strain (GLSepi), subendomyocardial global circumferential strain (GCSendo), mid-layer myocardial global circumferential strain (GCSmid), and subepimyocardial global circumferential strain (GCSepi).
There were no significant differences in age, body mass index (BMI), blood pressure, or left ventricular ejection fraction (LVEF) between the two groups. The end-diastolic interventricular septal thickness (IVST) was greater in the POI group (8.29 ± 1.32 vs. 7.66 ± 0.82, P = 0.008), and the POI group had lower E, E/A, and lateral e' (all P < 0.05). As for systolic functions,the POI group had lower GLSendo, GLSmid, GLSepi, GCSendo, GCSmid, and GCSepi (all P < 0.05).The intraobserver and interobserver coefficients of GLSendo, GLSmid, GLSepi, GCSendo, GCSmid, and GCSepi were greater than 0.900.
POI patients with normal LVEF may suffer from subclinical left ventricular myocardial systolic dysfunction. Echocardiography of layer-specific myocardial strain could more sensitively detect subclinical impairment of left ventricular systolic function in POI patients.
由于雌激素缺乏，卵巢早衰（POI）是缺血性心脏病和整体心血管疾病的独立危险因素。本研究旨在应用分层心肌应变对POI患者亚临床左心室心肌收缩功能变化进行早期定量评估。
纳入48例新诊断、未治疗的POI患者（POI组）和50例年龄、身高和体重匹配的健康女性受试者（对照组）。采用标准经胸超声心动图测量常规参数和分层应变参数。分层应变参数包括心内膜下心肌整体纵向应变（GLSendo）、中层心肌整体纵向应变（GLSmid）、心外膜下心肌整体纵向应变（GLSepi）、心内膜下心肌整体圆周应变（GCSendo）、中层心肌整体圆周应变（GCSmid）和心外膜下心肌整体圆周应变（GCSepi）。
两组患者的年龄、体重指数（BMI）、血压或左心室射血分数（LVEF）无显著差异。POI组舒张末期室间隔厚度（IVST）更大（8.29±1.32 vs. 7.66±0.82，P = 0.008），且POI组的E、E/A和侧壁e'更低（均P < 0.05）。至于收缩功能，POI组的GLSendo、GLSmid、GLSepi、GCSendo、GCSmid和GCSepi更低（均P < 0.05）。GLSendo、GLSmid、GLSepi、GCSendo、GCSmid和GCSepi的观察者内和观察者间系数均大于0.900。
LVEF正常的POI患者可能存在亚临床左心室心肌收缩功能障碍。分层心肌应变超声心动图能够更敏感地检测POI患者左心室收缩功能的亚临床损害。
