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压力-应变环在代谢综合征患者左室心肌做功改变中的评估价值

Evaluation value of pressure-strain loops in the changes of left ventricular myocardial work in patients with metabolic syndrome

    摘要
  • 摘要:
    目的 探讨压力-应变环（PSL）评估代谢综合征（MS）患者左室心肌做功改变情况的价值。
    方法 选取MS患者68例纳入研究组，并选取同期健康体检者50例纳入对照组，所有MS患者未发生左室重构。采用超声心动图对左室参数进行评价，并计算出左室质量指数（LVMI）。采用PSL测量整体做功指数（GWI）、整体做功功率（GWE）、整体有用功（GCW）、整体无用功（GWW）等左室整体心肌做功参数。对比2组左室整体心肌做功参数的变化及超声心动图参数。
    结果 2组受检者身高、性别、年龄、体表面积比较，差异无统计学意义（P>0.05），2组体质量、体质量指数、血压、血糖、血脂指标比较，差异有统计学意义（P < 0.05）。2组左室舒张末期内径（LVEDd）、左室射血分数（LVEF）比较，差异无统计学意义（P>0.05），2组左室舒张末期容积（LVEDV）、左室收缩末期容积（LVESV）、左室舒张末期后壁厚度（LVPWTd）、舒张末期室间隔厚度（IVSTd）、LVMI比较，差异有统计学意义（P < 0.05）。与对照组相比，研究组GWI、GWE、GCW、GLS均低于对照组，GWW高于对照组，差异有统计学意义（P < 0.05）。Pearson相关分析表明，GWI、GWE、GCW与GLS呈正相关（r=0.81、0.79、0.75，P < 0.01），GWW与GLS呈负相关（r=-0.71，P < 0.01）；GWI、GWE、GCW与LVEF呈正相关（r=0.68、0.65、0.66，P < 0.01），GWW与LVEF呈负相关（r=-0.60，P < 0.01）。GWI、GWE、GCW、GWW测量的组内相关系数分别为0.958、0.927、0.948、0.925，组间相关系数分别为0.918、0.947、0.925、9.943。
    结论 PSL可定量评估MS患者左室心肌做功的改变情况，且其具有良好的一致性。

     

    Abstract:
    Objective To investigate the changes of left ventricular myocardial work in patients with metabolic syndrome (MS) assessed by pressure-strain loops (PSL).
    Methods Sixty-eight patients with MS were included in study group, and 50 patients with healthy physical examination during the same period were included in control group. No left ventricular remodeling occurred in all MS patients. Left ventricular parameters were evaluated by echocardiography and left ventricular mass index (LVMI) was calculated. PSL was used to measure Global Work Index (GWI), Global Work Efficiency (GWE), Global Constructive Work (GCW), Global Work Waste (GWW) and other parameters of global left ventricular myocardial work. The changes of global left ventricular work parameters and echocardiographic parameters were compared between the two groups.
    Results There were no significant differences in height, gender, age and body surface area between the two groups (P>0.05), while there were significant differences in body mass, body mass index, blood pressure, blood glucose and blood lipid indexes between the two groups (P < 0.05). There were no significant differences in left ventricular end-diastolic diameter (LVEDd) and left ventricular ejection fraction (LVEF) between the two groups (P>0.05). There were statistically significant differences in left ventricular end-diastolic volume (LVEDV), left ventricular end-systolic volume (LVESV), left ventricular posterior wall thickness at end diastole (LVPWTd), interventricular septal wall thickness at end diastole (IVSTd) and LVMI between the two groups (P < 0.05). Compared with the control group, GWI, GWE, GCW and GLS of the study group were significantly lower than those of the control group, while GWW was significantly higher than that of the control group (P < 0.05). Pearson analysis showed that GWI, GWE and GCW were positively correlated with GLS (r=0.81, 0.79, 0.75, P < 0.01), while GWW was negatively correlated with GLS (r=-0.71, P < 0.01). GWI, GWE and GCW were positively correlated with LVEF (r=0.68, 0.65, 0.66, P < 0.01), while GWW was negatively correlated with LVEF (r=-0.60, P < 0.01). The intra-group correlation coefficients of GWI, GWE, GCW and GWW were 0.958, 0.927, 0.948 and 0.925, and the inter-group correlation coefficients were 0.918, 0.947, 0.925 and 9.943, respectively.
    Conclusion PSL can quantitatively assess changes in left ventricular work in MS patients with good consistency.

     

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