Chronic Mitral Regurgitation: Left Atrial Deformation Analysis by Two-Dimensional Speckle Tracking Echocardiography
Chronic Mitral Regurgitation: Left Atrial Deformation Analysis by Two-Dimensional Speckle Tracking Echocardiography
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DOI：
10.1111/j.1540-8175.2010.01329.x
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发表时间：
2011-03-01
影响因子：
1.5
通讯作者：
Mondillo, Sergio
中科院分区：
文献类型：
--
作者：
Cameli, Matteo;Lisi, Matteo;Mondillo, Sergio
背景：斑点跟踪超声心动图（STE）是一种独立于角度、客观量化心肌变形的新方法；它最近发展，使纵向心肌左房（LA）变形动力学的量化。为了研究慢性二尖瓣反流（MR）对这些功能性心房指标的影响，我们通过STE分析了一组无症状的慢性退行性MR患者的LA功能。方法：研究人群包括36例轻度MR患者，38例中度MR患者和42例重度MR患者。通过平均所有心房段来测量所有受试者的总体峰值心房纵向应变（Global PALS）。结果：所有病理组的年龄、性别和左室射血分数与对照组相当。轻度MR组的全球PALS（46.7 +/- 9.1%）高于对照组（40.5 +/- 6.2%,P < 0.001）；相反，与对照组（40.5 +/- 6.2%，方差分析总体P < 0.0001，所有两两比较P < 0.05）相比，中度MR组的总体PALS较低（25.7 +/- 7.1%），重度MR组进一步降低（13.2 +/- 5.2%）。在多变量分析中，E/Em比率成为全球PALS的主要独立决定因素。结论：我们的研究为不同程度MR的LA功能分析提供了新的见解，表明STE测量LA纵向应变可能被认为是早期检测无症状慢性MR患者LA依从性损害的有希望的工具（Echocardiography 2011;28:327-334）。
Background: Speckle tracking echocardiography (STE) is a novel method for the angle-independent and objective quantification of myocardial deformation; it has recently evolved, enabling the quantification of longitudinal myocardial left atrial (LA) deformation dynamics. To investigate the effects of chronic mitral regurgitation (MR) on these functional atrial indices, we analyzed LA function by STE in a group of asymptomatic patients with chronic degenerative MR. Methods: The study population included 36 patients with mild MR, 38 with moderate MR, and 42 with severe MR. 52 age-matched controls were also recruited. Global peak atrial longitudinal strain (global PALS) was measured in all subjects by averaging all atrial segments. Results: Age, gender, and LV ejection fraction in all pathological groups were comparable to those in the controls. Global PALS was higher in the mild MR group (46.7 +/- 9.1%) in comparison with the controls (40.5 +/- 6.2%; P < 0.001); instead global PALS was lower in the moderate MR group (25.7 +/- 7.1%) and further reduced in the severe MR group (13.2 +/- 5.2%) in comparison with the controls (40.5 +/- 6.2%; overall P < 0.0001 by ANOVA, P < 0.05 for all pairwise comparisons). In multivariate analysis, E/Em ratio emerged as the principal independent determinant of global PALS. Conclusions: Our study provides new insight for the LA function analysis in response to different degrees of MR, showing that STE measurements of LA longitudinal strain may be considered a promising tool for the early detection of impairment of LA compliance in patients with asymptomatic chronic MR. (Echocardiography 2011;28:327-334).