压力-应变环评价心脏淀粉样变左心室心肌做功的价值OA北大核心CSTPCD

Objective:To explore the value of pressure-strain loop(PSL)in evaluating myocardial work of left ventricle in patients with cardiac amyloidosis(CA)with different left ventricular ejection fraction(LVEF).Methods:Twenty-three patients with CA(Group CA1,16 cases,LVEF≥50%;Group CA2,seven cases,LVEF<50%)and 25 healthy subjects(control group)were enrolled.The difference of left ventricular longitudinal strain(LS)and myocardial work among groups were analyzed by PSL based on two-dimensional speckle tracking imaging.Results:①Compared to the control group,global longitudinal strain(GLS),global work index(GWI),global constructive work(GCW)and global work efficiency(GWE)were decreased in group CA1 and group CA2(P<0.05).Peak strain dispersion(PSD)and global wasted work(GWW)of left ventricle were increased in group CA1 and group CA2 compared to the control group(P<0.05).GLS and GWE were lower in group CA2 than in group CA1(P<0.05)while GWW was higher in group CA2 than in group CA1(P<0.05).②LS,myocardial work index(MWI),myocardial con-structive work(MCW),and myocardial work efficiency(MWE)in basal and apical segments were decreased in group CA1 and group CA2 compared to control group,myocardial wasted work(MWW)in apical segments were higher in group CA2 than group CA1 and control group(P<0.05).Relative apical sparing patterns of LS,MWI,MCW,and MWE were found in group CA1.However,this pattern was not found in MWI,MCW and MWE in group CA2.③GLS,GWW,and MWW in apical seg-ments,apical-to-base ratio of MWW had negative correlations with LVEF(P<0.05),while GWE and MWE in apical segments had positive correlations with LVEF(P<0.05).The major factors influenced LVEF were MWW in apical segments and GLS.Conclusion:The global and regional myocardial work are decreased in patients with CA.MWW in apical segments and GLS have a significant effect on LVEF.PSL is of great value to evaluate the myocardial work of left ventricle in patients with CA.