应变率成像结合大剂量多巴酚丁胺负荷试验评价早期冠心病左室心肌舒张功能  

The Evaluation of Diastolic Function in Early Myocardial Ischemia by Strain Rate Imaging Combined with High-Dose Dobutamine Stress Echocardiography

作　　者：Cyprien MBA MBA(恩巴) 邓又斌[1] 毕小军[1] 王文璇[1] 朱美华[1] 

机构地区：[1]华中科技大学同济医学院附属同济医院超声影像科,武汉市430030

出　　处：《中国超声医学杂志》2011年第7期624-627,共4页Chinese Journal of Ultrasound in Medicine

摘　　要：目的探讨应变率成像(SRI)结合大剂量多巴酚丁胺负荷超声心动图(DSE)评价早期冠心病左室心肌舒张功能变化。方法对28例可疑冠心病患者进行大剂量DSE,测量舒张早期峰值应变率(SRe)和舒张晚期峰值应变率(SRa),并进行冠心病组和正常对照组的比较。结果冠心病组缺血节段SRe在Dob剂量20μg/(kg·min)时达到最大,与静息状态比较差异有统计学意义;在Dob剂量30和40μg/(kg·min)时降低,与正常对照组、非缺血节段同一负荷状态比较差异有统计学意义。以Dob剂量40μg/(kg·min)时SRe≤1.70为截断值,预测缺血心肌舒张功能异常的敏感性和特异性分别为88.9%和83.3%。结论 SRe是反映心肌局部舒张功能变化敏感而特异的指标。Objective To assess the left ventricular diastolic function in early myocardial ischemia by strain rate imaging （SRI） combined with high-dose dobutamine stress echocardiography（DSE）. Methods High-dose DSE was performed in 28 patients with suspected coronary artery disease（CAD）. Early diastolic peak strain rate （SRe） and late diastolic peak strain rate （SRa） were measured. According to the results of coronary angiography （CAG）, myocardial segments were divided into control group and CAD group. The SRe and SRa average were calculated in all groups and were compared inside and between different groups. Results The maximum SRe in CAD ischemic group was obtained with dose of 20μg/（kg ·min） and SRe decreased significantly with dose of 30 and 40μg/（kg ·min） ,compared with the control group. When the cutoff value of SRe was less than 1.70s-1 , the sensitivity and specificity of diastolic function of myocardial ischemia were respectively 88.9% and 83.3%. Conclusions SRe is a sensitive and specific indicator in reflecting the reduction of diastolic function in regional myocardial ischemia.

关 键 词：超声心动描记术 多巴酚丁胺 应变率 冠心病 心肌缺血 

分 类 号：R541.4[医药卫生—心血管疾病]