二维斑点追踪技术对单支右冠脉病变患者左右心室功能的评价  

Assessment of left and right ventricular functions in patients with isolated disease of right coronary artery by two-dimensional speckle tracking imaging

作　　者：宋陈芳[1] 周青[1] 黄佳[1] 胡波[1] 邓倾[1] 郭瑞强[1] 

机构地区：[1]武汉大学人民医院超声科,430060

出　　处：《中华超声影像学杂志》2012年第8期665-669,共5页Chinese Journal of Ultrasonography

基　　金：中央高校基本科研业务费专项资金资助（20113（J20Z020004）

摘　　要：目的应用二维斑点追踪技术评价单支右冠脉病变患者左右心室的功能。方法对45例确诊为单支右冠脉病变的患者行超声心动图检查，30例有胸痛症状但冠脉造影未见明显狭窄的患者作为对照，记录左室长轴、心尖二腔及心尖四腔观的高帧二维图像，用二维应变软件获取左室18节段心肌纵向应变值、牛眼图及右室游离壁基底段、中间段和心尖段应变值。结果右冠脉狭窄但未发生心肌梗死的患者左室后壁基底段、中间段和心尖段，下壁基底段和中间段，后室间隔基底段、中间段应变值均减低（P均〈0．05）；左室整体应变值减低（P〈0．05）；右室游离壁中间段应变值减低（P〈0．05）。右冠狭窄且发生心肌梗死的患者左室前室间隔基底段、中间段，前壁心尖段，后壁基底段、中间段和心尖段，下壁基底段、中间段，以及后室间隔基底段、中间段应变值均减低（P均〈0．05）；左室整体应变值减低（P〈0．05）；右室游离壁中间段和心尖段应变值减低（P均〈0．05）。结论二维斑点追踪技术可评估左右心室功能，且单支右冠病变患者左右心室均有多个节段应变值减低、功能受损，以左室下、后壁，左室整体及右室游离壁中间段为甚。Objective To evaluate the usefulness of speckle tracking imaging（STI） for assessment of left ventricular（LV） and right ventricular （RV） functions in patients with isolated disease of right coronary artery. Methods 45 cases were diagnosed as single right coronary lesions given echoeardiography,30 cases had chest pain but coronary angiography had not seen the obvious narrow as a comparison. The two dimensional loop-cinec were obtained in apical 4-chamber view,apical 2-chamber view and long axis of LV view. Eighteen segments of LV longitudinal peak systolic strain,global peak systolic strain of each view and three segments of RV free wall were measured by two-dimensional strain software. Results In the patients who had right coronary lesions but did not happen myocardial infarction, the strain（S） values in the base, mid and apex segmental of LV post wall,the base and mid segmental of LV inferior wall and the base and mid segmental of LV septum were significantly lower（ P 〈0.05）. The S values in the mid segment of RV free wall was lower（ P 〈0.05）. In the patients who had right coronary lesions and myocardial infarction,the S values in the base,mid segmental of LV antsept,the apex segmental of LV anterior wall,the base,mid and apex segmental of LV post wall, the base and mid segmental of LV inferior wall and the base and mid segmental of LV septum were significantly lower（ P 〈0.05）. The S values in the mid and apex segments of RV free wall were lower （ P 〈 0.05）. And the LV global longitudinal strains were lower in the two groups （P〈0.05）. Conclusions STI is a new and useful technology for assessment ventrieular functions in patients with isolated disease of right coronary artery,and there are multiple segments impaired.

关 键 词：超声心动描记术 冠状动脉疾病 心室功能 

分 类 号：R445.1[医药卫生—影像医学与核医学] R543[医药卫生—诊断学]