二维斑点追踪技术定量评价冠状动脉慢性完全闭塞介入治疗效果  

Two-dimensional Speckle Tracking Imaging in the Quantitative Evaluation of Treatment Effect after Percutaneous Coronary Intervention in Patients with Chronic Total Occlusion

作　　者：卢荔红[1,2] 叶振盛[3] 郭薇[3] 陈斌[1,2] 陈威[1,2] 蒋辉[1,2] 

机构地区：[1]福建医科大学 省立临床医学院 [2]福建省心血管病研究所心内科,福州350001 [3]福建省心血管病研究所超声心动图室,福州350001

出　　处：《福建医科大学学报》2013年第3期153-157,共5页Journal of Fujian Medical University

基　　金：福建省科技计划重点项目(2013Y0024)

摘　　要：目的运用二维斑点追踪技术(STI)径向及圆周应变量化评价冠状动脉慢性完全闭塞(CTO)患者经皮冠状动脉介入治疗(PCI)前后左室心肌室壁运动功能变化,同时评价PCI治疗的效果。方法选择35例CTO患者,应用常规二维心动图检测PCI治疗术前、术后左室射血分数(LVEF)及室壁运动指数(WMSI);STI检测术前、术后左室基底水平、乳头肌水平及心尖部水平收缩期峰值径向(RS)及圆周应变(CS)。结果 (1)PCI治疗后CTO患者LVEF由治疗前(48.7%±6.90%)显著提高至(55.3%±7.31%)(P<0.05);左室WMSI由治疗前(1.52±0.17)显著降低至(1.33±0.25)(P<0.05);(2)PCI治疗后CTO患者基底水平、乳头肌水平、心尖水平部分室壁节段RS及CS与术前比较显著升高(P<0.05);运动减弱和运动消失节段RS和CS及运动正常节段RS与术前比较显著升高(P<0.05)。结论 STI技术能够准确定量评价CTO患者PCI治疗后左室心肌室壁运动功能,同时血管介入重建治疗可改善CTO患者左室心肌运动及功能。Objective To evaluate the changes of left ventricular myocardial motion and function with two-dimensional speckle tracking imaging before and after percutaneous coronary intervention (PCI) in patients with chronic total occlusion(CTO) and the effect of recanalization of CTO by PCI . Methods Thirty-five patients with chronic total occlusion were enrolled in this study ,The left ventricular ejection fraction(LVEF) and wall motion score index (WMSI) were measured with two-dimensional echocardio-graphy before and after PCI ;The left ventricular radial strain(RS) and circumferential stain(CS) in wall segments at the levels of base ,apillary muscle and apical were measured before and after PCI . Results (1) The LVEF increased significantly from (48 .7 ± 6 .90 )% before PCI to (55 .3 ± 7 .31 )% after PCI (P<0 .05);The left ventricular WMSI decreased significantly from (1 .52 ± 0 .17) before PCI to (1 .33 ± 0 .25) after PCI (P<0 .05);(2)The left ventricular RS and CS values in part of wall segments at the levels of base ,papillary muscle and apical increased significantly after PCI (P<0 .05) ,The left ven-tricular RS and CS values in hypokinetic ,akinetic wall segments and RS values in normal wall segments in-creased significantly after PCI (P<0 .05) . Conclusion The left ventricular myocardial motion can be ac-curately and quantitatively evaluated with STI before and after PCI in patients with CTO . Recanalization by PCI can improve left ventricular myocardial motion and the left ventricular function in patients with CTO .

关 键 词：动脉闭塞性疾病 冠状血管 慢性病 心室功能 左 心肌 心肌收缩 超声心动描记术 

分 类 号：R543.3[医药卫生—心血管疾病]