目的 采用斑点追踪超声心动图(STE)评价左心室不同舒张功能状态对左心房容积及功能的影响.方法 将107例受检者根据左心室不同舒张功能状态分成正常组、松弛异常组、假性正常组.利用STE技术测量和计算左心房最大容积指数(LAVImax)、左心房最小容积指数(LAVImin)、左心房收缩前容积指数(LAVIp)、左心房扩张指数(EI)、左心房被动射血分数(LAPEF)、左心房主动射血分数(LAAEF)、左心房总射血分数(LATEF).结果 随着左心室舒张功能逐渐降低,LAVImax、LAVIp、LAVImin逐渐增加(P＜0.01),LAAEF先增大后降低(P＜0.01)；与正常组相比,松弛异常组和假性正常组EI、LAPEF显著降低(P＜0.05),假性正常组LATEF显著降低(P＜0.01).E/Em与LAVImax、LAVIp、LAVImin呈显著正相关,LAVImax预测左心室舒张功能异常及鉴别正常和假性正常的敏感度和特异度分别为78％、98％及97％、100％.结论 STE为评价左心室不同舒张功能状态的左心房容积与功能提供了新方法；左心房容积及功能参数能较准确、敏感地反映左心室舒张功能受损程度.%Objective To investigate speckle tracking echocardiography (STE) in assessing the impact of different left ventricular diastolic functional status on left atrial volume and function. Methods Totally 107 subjects were enrolled and classified into normal group, abnormal group and pseudonormal group according to different left ventricular diastolic functional status. STE was utilized to measure and calculate the maximum left atrial volume index (LAVImax), the minimum left atrial volume index (LAVImin) , left atrial presystolic volume index (LAVIp), left atrial expansion index (ED , left atrial passive ejection fraction (LAPEF), left atrial active ejection fraction (LAAEF) and left atrial total ejection fraction (LATEF). Results With the enlargement of the extent of left ventricular diastolic dysfunction, LAVImax, LAVIp, LAVImin increased gradually (P<0. 01) , LAAEF firstly increased, and then decreased (P<0. 01). Compared with those of the normal group. El and LAPEF significantly decreased in both abnormal group and pseudonormal group (P<0. 05), LATEF significantly decreased in pseudonormal group (P<0. 01). There was close positive correlation between E/Em and LAVImax, LAVIp, LAVImin. Specificity and sensitivity of LAVImax in predicting left ventricular diastolic dysfunction and identifying normal from pseudonormal was 78%, 98% and 97%, 100%, respectively. Conclusion STE provides a new method in assessing left atrial volume and function under different left ventricular diastolic functional status. Left volume and the functional parameters can reflect the extent of left ventricular diastolic dysfunction accurately and specifically.
展开▼
