二维斑点追踪技术评价冠心病患者支架植入术后左心室整体功能的早期变化  

Study of early recovery of left ventricular rotation and torsion after percutaneous coronary intervention using two dimensional speckle tracking echocardiography

作　　者：李政[1] 潘翠珍[1] 舒先红[1] 董丽莉[1] 崔洁[2] 汤祥林[2] 梁立龙[2] 

机构地区：[1]复旦大学附属中山医院心脏超声科上海市心血管病研究所,上海200032 [2]复旦大学附属中山医院心内科 上海市心血管病研究所,上海200032

出　　处：《中华超声影像学杂志》2013年第6期466-469,共4页Chinese Journal of Ultrasonography

摘　　要：【摘要】目的应用二维斑点追踪技术评价左室射血分数（1eftventricularejectionfraction，LVEF）正常的冠心病患者左室旋转／扭转功能及经皮冠脉支架植入（percutaneouscoronaryintervention，PCI）术后的早期变化。方法正常志愿者11例（A组），23例行择期冠脉造影且LVEF正常的冠心病患者，分为轻度冠脉狭窄组（B组）与重度冠脉狭窄组（c组），对比3组二尖瓣水平旋转峰值角度（peakbasalrotation，BR）、心尖水平旋转峰值角度（peakapicalrotation，AR）、左室扭转峰值角度（peakleftventriculartorsion，LVT）及标化达峰时间；将LVT与上述指标行相关性分析；对比C组PCI24h后上述指标变化。结果B组及c组AR和I。VT较A组降低；C组二尖瓣水平扭转达峰时间较A组及B组提前（P〈O．05）；LVT与AR、BR、二尖瓣水平旋转达峰时间相关；PCI后C组BR及LVT增加。结论AR对缺血损伤敏感；LVEF正常的PCI患者二尖瓣水平达峰时间提前，可能既有代偿机制又有缺血心肌的限制；PCI后24hBR对再灌注治疗敏感，可早期预测PCI后24h的疗效。Objective To evaluate left ventricular rotation and torsion and its early recovery after percutaneous coronary intervention （PCI） in patients with coronary heart disease and normal left ventricular ejection fraction （LVEF） using two dimensional speckle tracking cchocardiography. Methods Twenty three consecutive patients with coronary heart disease and normal LVEF were divided into group B （with coronary stenosis 〈70%） and group C （with coronary stenosis 〉70% and with PCI）. Along with 11 healthy controls（group A）, indices including basal rotation （BR）, apical rotation fAR）, left ventricular torsion （LVT） and normalized time to peak were compared among groups, correlative analysis was made between LVT and each indices mentioned above,indices of group C before and 24 hours after PCI were compared. Results AR,LVT in group B and C reduced relative to group A （ P 〈0.05） ,meanwhile time to peak of BR in group C shortened relative to other groups. BR,AR and normalized time to peak of BR were correlated to LVT respectively. BR and LVT in group C increased after PCI（ P 〈0.05）. Conclusions AR was sensitive to ischemia, the reduction of time to peak of BR in group C might be restriction and compensation. Sensitive to early recovery of left ventrieular function after reperfusion,BR could be a predictive index of early effect of percutaneous coronary intervention.

关 键 词：超声心动描记术 冠状动脉疾病 支架 心室功能 左 斑点追踪显像 

分 类 号：R541.4[医药卫生—心血管疾病]