目的：本文研究扩张型心肌病（Dilated cardiomyopathy，DCM）引起的肺动脉高压经治疗后肺动脉压力及右心功能的改变。方法：超声应变技术测量60例左室受累的DCM患者治疗前后肺动脉压及右室应变的变化。结果：DCM合并肺动脉高压的患者（肺动脉收缩压≥35 mmHg），左室收缩及舒张功能较差。该类患者经保守治疗后，左室射血分数增高（P=0.046），肺动脉收缩压减低（P＜0.001），三尖瓣侧瓣环收缩期位移（TAPSE）无变化（P=0.102），右心室游离壁应变升高（P＜0.001）。与TAPSE相比，超声应变指标与核磁共振测量右室射血分数的相关性更优（r=0.808，P=0.008）。结论：超声应变较传统超声评估DCM治疗后右室功能改变更为敏感。

Objective: The aim of the study was to investigate the effect of conservative therapy on pulmonary hypertension(PH) and right ventricular(RV) function in DCM. Methods: This is a retrospective analysis of 60 consecutive DCM patients with evaluation of echocardiographic pulmonary artery systolic pressure(PASP) and right ventricular strain. Results: Compared with patients without PH, patients with PH(PASP≥35 mmHg) had worse left systolic and diastolic function. The ejection fraction increased post-therapy(P=0.046). Reduction of PASP post-therapy was evident in patients with PH(P＜0.001). The tricuspid annular plane systolic excursion(TAPSE) showed no significant difference post-therapy(P=0.102), however, the increase of the RV free wall strain was demonstrated post-therapy with strain imaging(P＜0.001). Compared with TAPSE, the correlation between RV free wall strain and right ventricular ejection fraction(magnetic resonance imaging) was better(r=0.808, P=0.008). Conclusion: The results of this study support the potential of strain imaging to estimate RV function, and adding significant value to conventional echocardiographic measurements.