【摘要】 目的 运用二维斑点追踪技术评估重度主动脉瓣狭窄(SAS)患者接受外科主动脉瓣置换术(SAVR)对左心室机械离散度(LV-MD)的影响。方法 前瞻性收集接受SAVR的35例SAS患者，同时选30名健康者为对照组。比较SAS患者SAVR术前、术后1周及健康组的左心机械离散度，分析SAVR对SAS患者左心机械离散度的影响，同时分析与术前LV-MD、左心室整体纵向应变(LV-GLS)相关的因素。结果 (1)SAS组术后LV-MD、基底段MD、中间段MD、LV-GLS绝对值均低于术前(P<0.05),心尖段MD则无明显差异(P>0.05)。(2)与对照组比较，SAS组术前、术后LV-GLS绝对值降低，而LV-MD、基底段MD、中间段MD、心尖段MD均增高(P<0.05)。(3)SAS患者术前LV-MD与年龄、左心室质量指数(LVMI)、LV-GLS呈正相关，与左心室射血分数(LVEF)呈负相关；术前LV-GLS与脑钠肽前体(Pro-BNP)呈正相关，与LVEF呈负相关。结论 SAS患者在接受SAVR后，其LV-MD得到改善。同时，术前LV-MD和LV-GLS与心脏结构及功能指标密切相关。更多还原

【Abstract】 Objective Using two-dimensional speckle tracking, to assess the impact of surgical aortic valve replacement(SAVR) on left ventricular-mechanical dispersion(LV-MD) in patients with severe aortic stenosis(SAS). Methods A prospective study was conducted on 35 patients with SAS who underwent SAVR, and 30 healthy individuals were selected as the control group. The LV-MD was compared among SAS patients before and 1 week after SAVR, as well as in healthy group. The impact of SAVR on LV-MD in SAS patients was analyzed. And the factors associated with preoperative LV-MD and left ventricular-global longitudinal strain(LV-GLS) was also analyzed. Results(1)In the SAS group, the postoperative LV-MD, basal segment MD, mid-ventricular segment MD, and the absolute value of LV-GLS were all lower than those before surgery(P<0.05). while there was no significant difference in the apical segment MD(P>0.05).(2)Compared with the control group, the absolute value of LV-GLS in the SAS group decreased both before and after surgery, while LV-MD, basal segment MD, mid-segment MD, and apical segment MD all increased(P<0.05).(3)In SAS patients, Preoperative LV-MD was positively correlated with age, left ventricular mass index(LVMI) and LV-GLS, and negatively correlated with left ventricular ejection fraction(LVEF). Preoperative LV-GLS was positively correlated with pro-brain natriuretic peptide(Pro-BNP) and negatively correlated with LVEF. Conclusions This study demonstrates that in patients with SAS, LV-MD is improved after SAVR. Additionally, preoperative LV-MD and LV-GLS are closely correlated with cardiac structural and functional parameters.更多还原