QTVI评价冠脉成形术对左前降支供血室壁节段运动功能的近期影响  

Assessment of Early Effect of Coronary Angioplasty on Wall of Left Anterior Descending Coronary with QTVI

作　　者：梅丽 蔡运昌 朱强 余杉 梁勤 赵宁 杨天和 张陈匀 

机构地区：[1]贵州省六盘水市人民医院,553001 [2]贵州省心血管病医院,贵阳550002

出　　处：《贵州医药》2007年第12期1074-1078,共5页Guizhou Medical Journal

摘　　要：目的应用多普勒超声心动图定量组织速度成像(QTVI)技术评价左前降支病变冠心病患者在冠脉成形术前后室壁节段运动功能的变化。方法因冠状动脉左前降支(LAD)狭窄接受支架置入或冠状动脉搭桥治疗的冠心病患者17例,分别于治疗前1天、治疗后1周测量左前降支供血区各节段心肌收缩期峰值速度(Vs)、舒张早期峰值速度(Ve)及舒张晚期峰值速度(Va)。另测量46例正常人的相同室壁节段的相同参数作为对照。结果(1)冠心病组治疗前左前降支供血区8个心肌节段的Vs、Ve及Va均低于正常对照组,Vs在6个节段、Ve在4个节段、Va在3个节段显著减低(P<0.05～0.01);(2)冠心病组治疗后1周室壁运动速度减低节段的3个参数较术前均有不同程度增加,6个节段的Vs、3个节段的Ve、2个节段的Va显著增加(P<0.05～0.01);其中4个节段的Vs、2个节段的Ve、2个节段的Va已恢复至正常组水平(P>0.05);(3)冠心病组17例术前有72个节段的Vs异常,术后l周25个节段恢复至正常。结论冠状动脉血管成形术后1周心肌节段性收缩及舒张功能明显改善。QTVI技术能定量分析左室壁局部心肌运动速度的变化。Objective To evaluate changes of regional wall motion before and after coronary angioplasty with quantitative tissue velocity imaging（QTVI）. Methods 17 patients with left anterior descending coronary artery （LAD） stenosis （≥70%） and 46 normal control subjects were included in this study. QTVI was performed one day before percutaneous transluminal coronary angioplasty （PTCA） ＋stent in 15 patients and coronary artery bypass graft （CABG） in 2 patients. A week after successful PTCA ＋ stent and CABG, peak systolic myocardial velocity（Vs）, peak early diastolic myocardial velocity （Ve） and peak late diastolic myocardial velocity （Va） were measured with QTVI at different wall segments. Results 1. Before coronary angioplasty, Vs, Ve and Va of all segments assigned by LAD were lower than those in normal subjects and Vs of 6 segments, Ve of 4 segments and Va of 3 segments were significantly lower. 2. A week after coronary angioplasty, the above segments showed more or less improvement. Vs of 6 segments, Ve 3 segments and Va of 2 segments were significantly increased and Vs of 4 segments, Ve, Va of 2 segments were normal. 3. Vs of 72 segments was abnormal, but 25 segments of them was normal after coronary angioplasty in CAD group. Conclusion The function of the abnormal regional wall has been improved after coronary angioplasty in a week. QTVI may provide a new real-time indicator objectively and quantitatively to estimate the change of velocity of regional myocardium myokinesis.

关 键 词：冠脉成形术 多普勒超声心动图 定量组织速度成像 左心功能 

分 类 号：R540.45[医药卫生—心血管疾病]