三维斑点追踪成像技术定量评价肾移植受者术后左心室整体应变

Three-dimensional speckle tracking imaging for quantitative evaluation of left ventricular global strain in renal transplant recipients

  • 摘要:
      目的  探讨采用三维斑点追踪成像(3D-STI)技术定量评价肾移植受者术后3个月内左心室整体应变的应用价值。
      方法  选取34例肾移植受者,分别于术前、术后7 d、术后1个月、术后3个月收集受者的血压、血清肌酐和他克莫司血药浓度等资料,同时对受者行常规超声心动图和3D-STI检查,收集受者超声心动图检查参数左心室舒张末期容积(LVEDV)、左心室收缩末期容积(LVESV)、左心室射血分数(LVEF)和3D-STI检查参数左心室整体纵向峰值应变(GPLS)、整体圆周峰值应变(GPCS)、整体径向峰值应变(GPRS)及整体面积峰值应变(GPAS)。比较受者术前、术后7 d、术后1个月、术后3个月上述指标的变化,分析应用3D-STI技术定量评价肾移植受者术后3个月内左心室整体应变的变化特点及其应用价值。
      结果  肾移植受者术前至术后3个月内各时间点间LVEF和GPCS比较,差异均无统计学意义(均为P > 0.05)。术前至术后3个月内各时间点间LVEDV、LVESV、GPLS、GPAS和GPRS比较,差异均有统计学意义(均为P < 0.001)。GPLS、GPAS、GPRS在术后1个月内呈连续下降趋势,术后3个月有所上升但仍低于术前水平。
      结论  应用3D-STI技术能够敏感地发现肾移植受者术后LVEF未见明显改变时左心室整体应变的改变,与常规超声心动图比较,3D-STI可以更准确地评价肾移植受者术后左心室整体应变的变化特点。

     

    Abstract:
      Objective  To evaluate the application value of three-dimensional speckle tracking imaging (3D-STI) in quantitatively evaluating the left ventricular global strain in recipients within 3 months after renal transplantation.
      Methods  Clinical data including blood pressure, serum creatinine and tacrolimus blood concentration of 34 renal transplant recipients were collected before operation, 7 d, 1 month and 3 months after operation, respectively. Meanwhile, conventional echocardiography and 3D-STI examination were performed. Echocardiographic parameters left ventricular end-diastolic volume (LVEDV), left ventricular end-systolic volume (LVESV) and left ventricular ejection fraction (LVEF) and 3D-STI parameters left ventricular global peak longitudinal strain (GPLS), global peak circumferential strain (GPCS), global peak radial strain (GPRS) and global peak area strain (GPAS) of recipients were collected. The changes of these parameters before operation, 7 d, 1 month and 3 months after operation were statistically compared. The changing characteristic and application value of 3D-STI in quantitatively evaluating the left ventricular global strain in recipients within 3 months after renal transplantation were evaluated.
      Results  LVEF and GPCS did not significantly differ at different time points (all P > 0.05), whereas LVEDV, LVESV, GPLS, GPAS and GPRS significantly differed at different time points from preoperative to within postoperative 3 months (all P < 0.001). GPLS, GPAS and GPRS trended to decline within postoperative 1 month, and slightly increased at 3 months after operation, which was still lower than the preoperative levels.
      Conclusions  Application of 3D-STI may sensitively detect the changes of left ventricular global strain in recipients after renal transplantation when no significant variations are observed in postoperative LVEF. Compared with conventional echocardiography, 3D-STI may more accurately evaluate the changes of left ventricular global strain in recipients after renal transplantation.

     

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