目的:利用实时三维超声心动图(RT-3DE)联合二维斑点追踪技术(2D-STI)对心尖肥厚型心肌病(AHCM)患者的左心房结构与功能进行全面评估,并探讨这些变化与临床指标的相关性。通过对比AHCM患者与健康对照组的差异,为AHCM的临床诊断、治疗及...目的:利用实时三维超声心动图(RT-3DE)联合二维斑点追踪技术(2D-STI)对心尖肥厚型心肌病(AHCM)患者的左心房结构与功能进行全面评估,并探讨这些变化与临床指标的相关性。通过对比AHCM患者与健康对照组的差异,为AHCM的临床诊断、治疗及预后评估提供新的依据。方法:本研究纳入了2022年1月至2024年1月在XX医院接受治疗的150例AHCM患者作为研究组,同时选择同期在该医院接受体检的150例健康人作为对照组。研究采用飞利浦EPIQ 7C高端彩色多普勒超声诊断系统,结合S5-1及X5-1型号的二维与三维经胸超声探头,对研究对象进行超声检查。通过RT-3DE技术测量左心房的容积参数,包括最大左心房容积(LAVmax)、最小左心房容积(LAVmin)等,并通过2D-STI技术评估左心房的心肌应变率参数,如左房储器期应变(LASr)、左房管道应变(LAScd)等。同时,收集研究对象的年龄、性别、体表面积(BSA)、血压、体重指数(BMI)等一般资料,并进行血常规、生化指标等实验室检测。采用SPSS 23.0软件进行统计分析,比较两组间的差异,并探讨相关性。结果:AHCM组患者的年龄显著高于对照组(P 0.05)。结论:AHCM患者左心房的结构与功能均发生了显著变化,具体表现为左心房容积增大、形态异常以及功能减退等。同时,心肌应变率参数与左心房功能指标之间存在显著相关性,提示心肌应变率参数可用于评估AHCM患者左心房功能的改变。这些发现不仅丰富了对AHCM病理生理机制的认识,也为临床诊断和治疗提供了新的视角和依据。未来研究可进一步探讨AHCM患者左心房结构与功能变化的机制及其与临床预后的关系,为制定更加精准的治疗方案提供科学依据。Objective: To comprehensively assess the structural and functional changes of the left atrium in patients with apical hypertrophic cardiomyopathy (AHCM) using real-time three-dimensional echocardiography (RT-3DE) combined with two-dimensional speckle tracking imaging (2D-STI), and to explore the correlations between these changes and clinical indicators. By comparing the differences between AHCM patients and healthy controls, this study aims to provide new evidence for the clinical diagnosis, treatment, and prognosis assessment of AHCM. Methods: This study enrolled 150 AHCM patients treated at XX Hospital from January 2022 to January 2024 as the study group, and 150 healthy individuals who underwent physical examinations at the same hospital during the same period as the control group. The Philips EPIQ 7C premium color Doppler ultrasound diagnostic system, equipped with S5-1 and X5-1 two-dimensional and three-dimensional transthoracic ultrasound probes, was used to perform ultrasound examinations on the study subjects. RT-3DE technology was employed to measure left atrial volume parameters, including maximum left atrial volume (LAVmax) and minimum left atrial volume (LAVmin). Meanwhile, 2D-STI technology was utilized to assess left atrial myocardial strain rate parameters, such as left atrial reservoir strain (LASr) and left atrial conduit strain (LAScd). Additionally, general information, including age, gender, body surface area (BSA), blood pressure, and body mass index (BMI), was collected, and laboratory tests for blood routine and biochemical indicators were conducted. Statistical analysis was performed using SPSS 23.0 software to compare differences between the two groups and explore correlations. Results: Patients in the AHCM group had significantly higher age (P 0.05). Conclusion: Significant changes have occurred in the structure and function of the left atrium in AHCM patients, manifested as increased left atrial volume, morphological abnormalities, and functional impairment. Meanwhile, there is a significant correlation between myocardial strain rate parameters and left atrial functional indicators, suggesting that myocardial strain rate parameters can be used to assess left atrial function in AHCM patients. These findings not only enrich our understanding of the pathophysiological mechanisms of AHCM but also provide new perspectives and evidence for clinical diagnosis and treatment. Future studies can further explore the mechanisms underlying the structural and functional changes of the left atrium in AHCM patients and their relationship with clinical prognosis, providing a scientific basis for developing more precise treatment plans.展开更多
文摘目的:利用实时三维超声心动图(RT-3DE)联合二维斑点追踪技术(2D-STI)对心尖肥厚型心肌病(AHCM)患者的左心房结构与功能进行全面评估,并探讨这些变化与临床指标的相关性。通过对比AHCM患者与健康对照组的差异,为AHCM的临床诊断、治疗及预后评估提供新的依据。方法:本研究纳入了2022年1月至2024年1月在XX医院接受治疗的150例AHCM患者作为研究组,同时选择同期在该医院接受体检的150例健康人作为对照组。研究采用飞利浦EPIQ 7C高端彩色多普勒超声诊断系统,结合S5-1及X5-1型号的二维与三维经胸超声探头,对研究对象进行超声检查。通过RT-3DE技术测量左心房的容积参数,包括最大左心房容积(LAVmax)、最小左心房容积(LAVmin)等,并通过2D-STI技术评估左心房的心肌应变率参数,如左房储器期应变(LASr)、左房管道应变(LAScd)等。同时,收集研究对象的年龄、性别、体表面积(BSA)、血压、体重指数(BMI)等一般资料,并进行血常规、生化指标等实验室检测。采用SPSS 23.0软件进行统计分析,比较两组间的差异,并探讨相关性。结果:AHCM组患者的年龄显著高于对照组(P 0.05)。结论:AHCM患者左心房的结构与功能均发生了显著变化,具体表现为左心房容积增大、形态异常以及功能减退等。同时,心肌应变率参数与左心房功能指标之间存在显著相关性,提示心肌应变率参数可用于评估AHCM患者左心房功能的改变。这些发现不仅丰富了对AHCM病理生理机制的认识,也为临床诊断和治疗提供了新的视角和依据。未来研究可进一步探讨AHCM患者左心房结构与功能变化的机制及其与临床预后的关系,为制定更加精准的治疗方案提供科学依据。Objective: To comprehensively assess the structural and functional changes of the left atrium in patients with apical hypertrophic cardiomyopathy (AHCM) using real-time three-dimensional echocardiography (RT-3DE) combined with two-dimensional speckle tracking imaging (2D-STI), and to explore the correlations between these changes and clinical indicators. By comparing the differences between AHCM patients and healthy controls, this study aims to provide new evidence for the clinical diagnosis, treatment, and prognosis assessment of AHCM. Methods: This study enrolled 150 AHCM patients treated at XX Hospital from January 2022 to January 2024 as the study group, and 150 healthy individuals who underwent physical examinations at the same hospital during the same period as the control group. The Philips EPIQ 7C premium color Doppler ultrasound diagnostic system, equipped with S5-1 and X5-1 two-dimensional and three-dimensional transthoracic ultrasound probes, was used to perform ultrasound examinations on the study subjects. RT-3DE technology was employed to measure left atrial volume parameters, including maximum left atrial volume (LAVmax) and minimum left atrial volume (LAVmin). Meanwhile, 2D-STI technology was utilized to assess left atrial myocardial strain rate parameters, such as left atrial reservoir strain (LASr) and left atrial conduit strain (LAScd). Additionally, general information, including age, gender, body surface area (BSA), blood pressure, and body mass index (BMI), was collected, and laboratory tests for blood routine and biochemical indicators were conducted. Statistical analysis was performed using SPSS 23.0 software to compare differences between the two groups and explore correlations. Results: Patients in the AHCM group had significantly higher age (P 0.05). Conclusion: Significant changes have occurred in the structure and function of the left atrium in AHCM patients, manifested as increased left atrial volume, morphological abnormalities, and functional impairment. Meanwhile, there is a significant correlation between myocardial strain rate parameters and left atrial functional indicators, suggesting that myocardial strain rate parameters can be used to assess left atrial function in AHCM patients. These findings not only enrich our understanding of the pathophysiological mechanisms of AHCM but also provide new perspectives and evidence for clinical diagnosis and treatment. Future studies can further explore the mechanisms underlying the structural and functional changes of the left atrium in AHCM patients and their relationship with clinical prognosis, providing a scientific basis for developing more precise treatment plans.
