应变率成像评价冠状动脉支架置入术前后左室舒张功能的临床研究  

Strain Rate Imaging for Analysis of Left Ventricular Diastolic Function after Stent Implantation in Patients with Coronary Heart Disease

作　　者：洪玮[1] 郭瑞强[1] 陈金玲[1] 周青[1] 初洪刚[1] 姜霞[1] 

机构地区：[1]武汉大学人民医院超声影像科,武汉市430060

出　　处：《中国超声医学杂志》2008年第12期1128-1131,共4页Chinese Journal of Ultrasound in Medicine

摘　　要：目的探讨应变率成像(SRI)技术定量评价冠心病患者冠状动脉支架置入术前后左室舒张功能的临床价值。方法25例冠心病患者于支架置入术前后行超声心动图检查,采用脉冲多普勒获取二尖瓣口血流频谱图像并测量二尖瓣口E峰(VE)、A峰(VA)及E峰下降时间(EDT),采用应变率成像获取左室狭窄冠脉供血节段(狭窄节段)和非狭窄冠脉供血节段(非狭窄节段)的收缩期峰值应变率SRS、舒张早期峰值应变率SRE及舒张晚期峰值应变率SRA,计算术后VE的增长率ΔVE%及SRE的增长率ΔSRE%,比较分析术前术后各项观测指标。结果支架置入术前狭窄节段与非狭窄节段的SRS无显著差异(P>0.05),而狭窄节段的SRE明显低于非狭窄节段(P<0.01)。术后各节段的SRS及非狭窄节段的SRE无显著变化(P>0.05),而狭窄节段的SRE显著增加(P<0.01),其增长率ΔSRE%显著高于非狭窄节段(P<0.01),且25例患者狭窄节段的ΔSRE与二尖瓣口的ΔVE成显著正相关(r=0.54,P<0.01)。结论应变率成像技术可定量检测心肌运动变化情况,监测支架置入术前后左室局部心肌功能。Objective To explore clinical value of strain rate imaging （SRI） in evaluating left ventricular diastolic function before and after stent implantation in Coronary Heart Disease （CHD） . Methods 25 patients with CHD were enrolled in the study before and after stent implantation. LV filling variables were obtained from pulsed wave Doppler recordings of the transmitral flow velocity. Then peak early diastolic velocity （E）, peak atrial systolic velocity （A）, deceleration time of the E wave and △VE% were measured. Peak strain rate during systole （SRs）, rapid filling （SRE） and the percent increase of SRE （△SRE%） in the stenotic segments and non-stenotic segments of left ventricular were measured. Results Before stent implantation, SRs had no significant differences in all segements （P〉0.05） . Compared with non-stenotic segments, SREin stenotic segments decreased significantly （P〈0.01） . SRs and △SRE% in stenotic segments increased significantly after stent implantation （P〈 0.01） and were obviously higher than those in non stenotic segments （P〈0.01） . There wan a significant positive correlation between the sum of △SRE in narrowed segments and △VE （r=0. 54, P〈0. 01） .Conclusions SRI can quantitively detect changes of myocardial motion, and real time quantify left ventricular diastolic function after stent implantation.

关 键 词：应变率成像 超声心动描记术 冠心病 支架置入术 左室舒张功能 

分 类 号：R541.4[医药卫生—心血管疾病] R445.1[医药卫生—内科学]