纵向、径向及周向二维应变评价冠心病患者左心室局部收缩功能异常  

Longitudinal, radial and circumferential 2-dimensional strain for quantitative analysis of regional left ventricular systolic dysfunction in patients with coronary artery disease

作　　者：李燕[1] 吕清[1] 王新房[1] 谢明星[1] 张静[1] 丁尚伟[1] 陈明[1] 王静[1] 贺林[1] 胡莉君[1] 李薇玢[1] 

机构地区：[1]华中科技大学同济医学院附属协和医院超声影像科,武汉430022

出　　处：《中华超声影像学杂志》2009年第4期277-280,共4页Chinese Journal of Ultrasonography

摘　　要：目的应用二维应变超声心动图定量分析静息状态下冠心病患者局部心肌纵向、径向及周向的收缩期峰值应变，了解静息状态下冠状动脉狭窄对左室局部心肌收缩功能的影响。方法26例冠心病患者和26例健康志愿者接受超声检查，获取心尖四腔观、二腔观及左心长轴观和左室短轴观（二尖瓣环、乳头肌和心尖水平）二维灰阶图像，分析各个心肌节段的纵向、径向和周向的收缩期峰值应变。按左室18节段划分法，将26例冠心病患者的共194个病变心肌节段按供血冠脉狭窄程度分为两组：A组为冠脉狭窄≤70％供血的心肌，B组为冠脉狭窄〉70％供血的心肌。结果A组共90个节段，其纵向收缩期峰值应变（SL）明显低于对照组（P〈0．05），而径向收缩期峰值应变（SR）和周向收缩期峰值应变（SC）低于对照组，但差异无统计学意义（P〉0．05）；B组共104个节段，其SL、SR和SC均明显低于对照组（P〈0．05）；A组和B组之间SL、SC和SR的差异有统计学意义（P〈0．05）。结论二维应变超声心动图能准确评价冠心病患者左室局部收缩功能异常，局部心肌SL、SR和SC的变化可反映冠脉狭窄严重程度。Objective To assess longitudinal, radial and circumferential systolic strain of regional myocardium in patients with coronary artery disease by 2-dimensional strain echocardiography, and to explore stenosis of coronary artery impacting on regional left ventricular systolic dysfunction in quietscent condition. Methods Twenty-six patients with coronary artery disease were entrolled into this study and 26 healthy volenteers in the control group. The two-dimensional loop cinec were obtained in apical 4-chamber view,apical 2-chamber view and long axis view of left venricular, and three levels of the short axis views （mitral valve,papillary muscle and cardiac apex）. According to left ventricle 18 segments divla, there were 194 affected myocardiums in 26 cases. According to stenosis degrees of coronary artery, the affected myocardiums were divided into two groups： group A （coronary stenosis degree≤ 70%） and group B （coronary stenosis degree〉70 % ）. Longitudinal, radial and circumferential systolic strain （SL, SR, SC） from regional myocardium were analyzed. Results Group A had 90 segments. Compared with control group,SL was decreased significantly from control group （ P 〈0.05） ,while there were no significantly differences in SC and SR （P 〉0.05）. Group B had 104 segments. Compared with control group, SL, SC and SR were decreased significantly in group B（ P 〈0.05）. There were significant differences in SL,SC and SR between group A and group B（ P〈0.05）. Conclusions Systolic dysfunction of left ventricular regional myocardium in patients with coronary artery disease could be aceuratly analyzed by 2 dimensional strain eehocardiography. Changes of SL,SC and SR of regional myocardium could reflect coronary stenosis severity degree.

关 键 词：超声心动描记术 冠状动脉疾病 心室功能  左 二维应变 

分 类 号：R686[医药卫生—骨科学]