背景:缺铁性贫血(IDA)是世界范围内常见的健康问题。这项研究的目的是使用左心室压力应变环(LV-PSL)无创定量评估IDA患者左心室收缩功能的早期变化。
方法:选择62例IDA患者,根据血红蛋白(Hb)浓度分为两组:B组Hb>9g/dL,C组6g/dL结果:与A组相比,B组GWI和GCW均降低(P均<0.01)。与B组和A组比较,GLS,GWI,GCW和GWE,E/A都减少了,和GWW,LVEDV,LVESV,C组E/平均E'均升高(均P<0.01)。GLS与GWI呈正相关,GCW,和GWE(r=0.679,0.681和0.447,均P<0.01),与GWW呈负相关(r=-0.411,均P<0.01)。对于GWI来说,ROC曲线下面积(AUROC)为0.783。IDA中检测左心室收缩功能异常的最佳GWI阈值为1763mmHg%,敏感性为0.71,特异性为0.78。
结论:LV-PSL可以无创性定量评估左心室射血分数保留的IDA患者的早期左心室收缩功能受损,与其他参数相比,GWI具有较高的敏感性和特异性。
BACKGROUND: Iron deficiency anemia (IDA) is a common health problem worldwide. The objective of this study was to noninvasively and quantitatively evaluate early changes in left ventricular systolic function in patients with IDA using the left ventricular press-strain loop (LV-PSL).
METHODS: Sixty-two patients with IDA were selected and divided into two groups based on hemoglobin (Hb) concentration: Group B with Hb > 9 g/dL and group C with 6 g/dL < Hb < 9 g/dL. Thirty-three healthy individuals were used as the control (Group A). The global longitudinal strain (GLS), global work index (GWI), global constructive work (GCW), global waste work (GWW), global work efficiency (GWE) were derived using LV-PSL analysis. Receiver operating characteristic (ROC) curves were constructed for MW parameters to detect abnormal left ventricular systolic function in IDA patients.
RESULTS: Compared to group A, GWI and GCW were reduced in group B (both P < 0.01). Compared with groups B and A, GLS, GWI, GCW and GWE, and E/A were all diminished, and GWW, LVEDV, LVESV, and E/mean e\' were all increased in group C (all P < 0.01). GLS was positively correlated with GWI, GCW, and GWE (r = 0.679, 0.681, and 0.447, all P < 0.01), and negatively associated with GWW (r = - 0.411, all P < 0.01). For GWI, area under the ROC curve (AUROC) was 0.783. The optimal GWI threshold for detecting abnormal LV systolic function in IDA was1763 mmHg%, with sensitivity of 0.71 and specificity of 0.78.
CONCLUSIONS: LV-PSL allows noninvasive quantitative assessment of early impaired LV systolic function in IDA patients with preserved LV ejection fraction, and GWI has high sensitivity and specificity compared with other parameters.