Objective: To investigate the characteristics of left ventricular longitudinal strain (LS) in myocardial amyloidosis (CA), hypertrophic cardiomyopathy (HCM) and Fabry disease (FD), as well as the correlation between left ventricular LS and these diseases. Methods: A total of 14 CA patients, 28 HCM patients and 5 FD patients who visited the Department of Cardiology of the First Affiliated Hospital of Suzhou University from June 2017 to November 2019 were retrospectively included. EchoPAC software was used to analyze left ventricular LS, and univariate logistic regression analysis was used to analyze the correlation between echocardiographic LS indexes and various myocardial hypertrophy diseases. The receiver operating characteristic (ROC) curve was used to assess the sensitivity and specificity of echocardiograph LS indexes in the diagnosis of various myocardial hypertrophy diseases. Results: There were significant differences in LS of left ventricular basal segment, inferior wall, posterior wall, lateral wall and posterior septum among the three groups (P<0.05). The absolute value of LS in the left ventricular basal segment decreased in the CA group; the absolute value of LS in left ventricular posterior wall and lateral wall decreased significantly in the FD group (P<0.05); the absolute values of LS in left ventricular basal segment, inferior wall, posterior septum, lateral wall and posterior wall increased significantly in the HCM group (P<0.05). The absolute value of LS < 7.9% in the left ventricular basal segment, or > 13.2% in the inferior wall and > 9.2% in the basal segment, or < 8.3% in the lateral wall and < 7.9% in the posterior wall were the indicators of high sensitivity and specificity in the diagnosis of CA, HCM and FD, respectively. Conclusions: Left ventricular LS was an important index to differentiate myocardial hypertrophy. Combined with their respective clinical characteristics, it could provide certain reference value for clinical practice.
目的： 探讨心肌淀粉样变性（CA）、肥厚型心肌病（HCM）及法布里病（FD）的左室纵向应变（LS）表现特点，研究左室LS与其相关性。 方法： 回顾性纳入2017年6月至2019年11月至苏州大学附属第一医院心内科就诊的CA患者14例、HCM 28例及FD 5例，采用EchoPAC软件分析左室LS，采用单因素logistic回归分析探查心脏超声LS指标与各类心肌肥厚疾病的相关性，受试者工作特征（ROC）曲线评估心脏超声LS指标诊断各类心肌肥厚疾病的灵敏度和特异度。 结果： 三组患者在左室基底段、下壁、后壁、侧壁、后间隔LS中的差异均有统计学意义（均P<0.05），其中CA组左室基底段LS绝对值降低，FD组在左室后壁、侧壁LS绝对值明显降低（P<0.05），HCM组在左室基底段、下壁、后间隔、侧壁、后壁LS绝对值均明显增高（均P<0.05）。左室基底段LS绝对值<7.9%、下壁>13.2%和基底段>9.2%、侧壁<8.3%和后壁<7.9%分别是诊断CA、HCM及FD的高度灵敏度及特异度指标。 结论： 左室LS是鉴别心肌肥厚的重要指标，结合各自临床特点，可为临床提供一定参考价值。.
Keywords: Amyloidosis; Fabry disease; Hypertrophic cardiomyopathy; Left ventricular longitudinal strain.