目的：应用三维斑点追踪成像（3D-STI）技术分析不同年龄段正常成人左房心肌应变值及其达峰时间的变化，探讨其与年龄的关系。方法：194例健康志愿者按年龄分为青年组（18~＜45岁，n=96）、中年组（45~＜60岁，n=59）和老年组（≥60岁，n=46），获取志愿者一般资料并行超声心动图检查，获取并存储左室心尖四腔全容积三维图像。应用3DT软件对图像进行分析，获取并比较左房左室收缩期整体环向应变峰值（GPCS）、整体纵向应变峰值（GPLS）、整体面积应变峰值（GPAS）及整体环向应变达峰时间（TGPCS）、整体纵向应变峰值达峰时间（TGPLS）和整体面积应变达峰时间（TGPAS），进一步分析各应变峰值与左房射血分数的相关性。结果：与青年组和中年组相比，老年组GPCS、GPLS、GPAS显著降低（P＜0.05），TGPCS显著增加（P＜0.05）；与青年组相比，中年组和老年组TGPLS和TGPAS显著增加（P＜0.05）；青年组和中年组的各应变值和TGPCS以及中年组和老年组中TGPLS和TGPAS差异均无统计学意义（P＞0.05），并且各峰值应变与左房射血分数均显著相关（r=0.62~0.78，P＜0.05）。结论：3D-STI技术能够检测左房心肌的运动形变信息，反映不同年龄段正常成人左心房心肌的应变规律，且可结合左房射血分数，更为全面地评估左房的功能，可作为临床早期评价左房功能不全的有利工具。
Abstract
Objective: To determine the left atrial(LA) function by examining the LA peak strains and time-to-peak strains using three-dimensional speckle tracking imaging(3D-STI) and explore its value in clinical application. Methods: A total of 194 volunteers were divided into adolescence, middle-aged and elderly groups according to their age. Apical four-chamber and two-chamber full-volume images were acquired in all subjects and analyzed by off-line 3D-STI analysis software. The global peak circumferential strain(GPCS), global peak longitudinal strain(GPLS), global peak area strain(GPAS), the time to peak circumferential strain(TGPCS), the time to peak longitudinal strain(TGPLS) and the time to peak area strain(TGPAS) of left atrium were obtained and compared, and then analyzed the correlation between these strains and left atrial total ejection fraction. Results: The LA global peak strains were significant decreased and TGPCS was significant increased in the elderly group when compared with the adolescence and middle-aged groups(P＜0.05); TGPLS and TGPAS were largely increased in the middle-aged group and elderly group compared to the adolescence group(P＜0.05), whereas for all the three global peak strains and TGPCS, no significant difference was found between the adolescence group and middle-aged group, also, there was no significant difference in TGPLS and TGPAS between the middle-aged group and elderly group. There was a good correlation between all the three global peak strains and left atrial ejection fraction. Conclusion: The 3D-STI technology can evaluate LA function in different age healthy adults, which has great importance in preventing and early monitoring subclinical cardiovascular disease.
关键词
心房功能 /
左 /
超声检查 /
多普勒 /
彩色
Key words
Atrial function, left /
Ultrasonography, Doppler, color
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