2026 年第 7 期 第 21 卷

右心室整体纵向应变与肺动脉收缩压比值对左心室心肌致密化不全患者不良预后的预测价值

Predictive value of right ventricular global longitudinal strain/pulmonary artery systolic pressure ratio for adverse prognosis in patients with left ventricular noncompaction

作者：张米雪1孙宁2臧淑婷1王晓敏1付秀秀1

英文作者：Zhang Mixue1 Sun Ning2 Zang Shuting1 Wang Xiaomin1  Fu Xiuxiu1

单位：1青岛大学附属医院心脏超声科，青岛266003；2青岛大学附属医院肝胆胰外科，青岛266003

英文单位：1Department of Cardiac Ultrasound Affiliated Hospital of Qingdao University Qingdao 266003 China; 2Department of Hepatobiliary Pancreatic Surgery Affiliated Hospital of Qingdao University Qingdao 266003 China

关键词：左心室心肌致密化不全；斑点追踪成像技术；右心室整体纵向应变与肺动脉收缩压比值

英文关键词：Leftventricularnoncompaction;Speckletrackingimaging;Ratioofrightventriculargloballongitudinalstraintopulmonaryarterysystolicpressure

• 摘要：

• 目的 应用斑点追踪成像技术（STI）评估左心室心肌致密化不全（LVNC）患者的右心室功能，探讨使用右心室整体纵向应变（RVGLS）与肺动脉收缩压（PASP）比值预测LVNC患者不良结局的效能。方法 前瞻性纳入2023年11月至2025年6月就诊于青岛大学附属医院的42例LVNC患者，按左心室射血分数（LVEF）中位数将其分为A组（LVEF≤43%，21例）、B组（LVEF＞43%，21例），并同期采集42例健康成年人作为对照组（C组）。应用STI测量RVGLS并计算RVGLS/PASP。采用线性回归分析RVGLS/PASP与其他超声参数之间的相关性。应用受试者工作特征（ROC）曲线分析RVGLS/PASP评估LVNC患者不良预后的价值。结果 与A组患者相比，B组及C组患者左心室整体纵向应变（LVGLS）、RVGLS、右心室游离壁纵向应变（RVFWLS）及RVGLS/PASP升高（均P＜0.05）；与C组患者相比，B组患者LVGLS、RVGLS及RVGLS/PASP降低（均P＜0.05）。多元线性回归分析显示二尖瓣环内侧壁舒张早期运动速度、左心房容积指数及RVFWLS均与RVGLS/PASP独立相关（均P＜0.05）。ROC曲线显示，RVGLS/PASP预测LVNC患者不良预后结局的效能最高,曲线下面积为0.856（95%置信区间：0.744～0.967）。结论 LVNC患者的右心室功能减低，RVGLS/PASP可用于评价LVNC患者的右心室功能并预测其不良预后，具有重要的临床意义。

• Objective To evaluate right ventricular function in patients with left ventricular noncompaction (LVNC) by speckle tracking imaging (STI), and to investigate the predictive efficiency of right ventricular global longitudinal strain (RVGLS)/pulmonary artery systolic pressure (PASP) ratio for adverse outcomes in LVNC patients. Methods A total of 42 LVNC patients admitted to Affiliated Hospital of Qingdao University from November 2023 to June 2025 were prospectively enrolled. According to the median left ventricular ejection fraction (LVEF), the patients were divided into group A (LVEF ≤43%, 21 cases) and group B (LVEF ＞43%, 21 cases). Meanwhile, 42 healthy adults were enrolled as control group (group C). STI was used to measure RVGLS and calculate RVGLS/PASP ratio. Linear regression analysis was performed to analyze the correlation between RVGLS/PASP ratio and other ultrasonic parameters. Receiver operating characteristic (ROC) curve was applied to analyze the value of RVGLS/PASP ratio in evaluating adverse prognosis of LVNC patients. Results Compared with group A, left ventricular global longitudinal strain (LVGLS), RVGLS, right ventricular free wall longitudinal strain (RVFWLS) and RVGLS/PASP ratio were increased in group B and group C (all P＜0.05). Compared with group C, LVGLS, RVGLS and RVGLS/PASP ratio were decreased in group B (all P＜0.05). Multiple linear regression analysis showed that medial early diastolic mitral annular velocity, left atrial volume index and RVFWLS were independently correlated with RVGLS/PASP ratio (all P＜0.05). ROC curve analysis indicated that RVGLS/PASP ratio had the highest predictive efficiency for adverse prognosis of LVNC patients, with an area under the curve of 0.856 (95% confidence interval: 0.744-0.967). Conclusion Right ventricular function is decreased in LVNC patients. RVGLS/PASP ratio can be used to evaluate right ventricular function and predict adverse prognosis in LVNC patients, which has important clinical significance.