【摘要】 目的观察心脏MRI应变技术评估高血压患者左心室功能的可行性。方法对88例高血压患者(高血压组)和28名健康志愿者(正常组)行心脏MR检查。将高血压组中血压140～159/90～99 mmHg者纳入Ⅰ组(32例),160～179/100～109 mmHg为Ⅱ组(28例),≥180/110 mmHg为Ⅲ组(28例)。对比各组间左心室心脏MRI参数及心肌应变参数。采用多元线性回归分析心肌应变影响因素。结果高血压各组舒张晚期峰值充盈率(PFR2)、舒张早期峰值充盈率(PFR1)/PFR2、舒张晚期充盈量(FV2)、舒张早期充盈量(FV1)/总充盈量(FV)与正常组差异均有统计学意义(P均<0.05),Ⅰ、Ⅲ组间FV2差异有统计学意义(P<0.05),Ⅲ组FV均大于其他3组(P均<0.05)。高血压各组整体纵向应变(GLS)、整体周向应变(GCS)及舒张期整体纵向峰值应变率(GLPDSR)、舒张期整体周向峰值应变率(GCPDSR)、舒张期整体径向峰值应变率(GRPDSR)均低于正常组(P均<0.05);Ⅰ、Ⅲ组间GLS、整体径向应变(GRS)及GCPDSR、GRPDSR差异均有统计学意义(P均<0.05);Ⅱ、Ⅲ组间GCPDSR差异有统计学意义(P<0.05)。高血压患者性别、收缩压均与GLS、GCS、GRS有关,病程与GLS有关,年龄、PFR1与GRS有关(P均<0.05)。结论心脏MRI应变技术可早期评估高血压患者左心室功能。更多还原

【Abstract】 Objective To observe the feasibility of cardiac MRI strain techniques in evaluation on left ventricular function in hypertensive patients. Methods Cardiac MRI examination was performed in 88 hypertensive patients(hypertension group) and 28 healthy volunteers(normal group). Patients with hypertension were further grouped according to blood pressure, those with 140-159/90-99 mmHg were enrolled in group Ⅰ(32 cases), 160-179/100-109 mmHg in group Ⅱ(28 cases), ≥180/110 mmHg in group Ⅲ(28 cases). Left ventricular parameters of cardiac MRI and the myocardial strain were compared among groups, and multivariate linear regression analysis was used to analyze the relevant influencing factors of strain. Results There were significant differences of the second diastolic peak filling rate(PFR2), the ratio of first diastolic peak filling rate(PFR1)/PFR2, second filling volume(FV2), the ratio of first filling volume(FV1)/total filling volume(FV) among hypertension groups and normal group(all P<0.05), also of FV2 between groupⅠ and Ⅲ(P<0.05). FV value of Ⅲ group was significantly higher than that of the other groups(all P<0.05). The global longitudinal strain(GLS), global circumferential strain(GCS), global longitudinal peak diastolic strain rate(GLPDSR), global circumferential peak diastolic strain rate(GCPDSR) and global radial peak diastolic strain rate(GRPDSR) in hypertension groups were lower than those in normal group(all P<0.05). There were statistically significant differences of GLS, global radial strain(GRS), GCPDSR and GRPDSR between groupⅠ and Ⅲ(all P<0.05).GCPDSR was statistically different between group Ⅱand Ⅲ(P<0.05). The gender and systolic blood pressure of hypertension patients were all related to GLS, GCS and GRS; the course of disease was related to GLS, and the age and PFR1 were related to GRS(all P<0.05). Conclusion Cardiac MRI strain technique could be used for early evaluating left ventricular function in patients with hypertension.更多还原