斑点追踪与组织多普勒成像评价右冠状动脉再通术前后右心室功能变化  

Changes of Right Ventricular Function with Speckle Tracking Imaging and Tissue Doppler Imaging After Successful Percutaneous Coronary Intervention Recanalization of Right Coronary Artery

作　　者：田川[1] 李玉宏[1] 邢园园[1] 葛丽丽[1] 张佳怡[1] 

机构地区：[1]辽宁医学院附属第一医院超声科,辽宁锦州121001

出　　处：《中国医学影像学杂志》2014年第1期41-44,共4页Chinese Journal of Medical Imaging

基　　金：辽宁省自然科学基金项目(2013022020)

摘　　要：目的探讨二维斑点追踪显像(2DSTI)和组织多普勒成像(TDI)检测右冠状动脉慢性完全闭塞(RCA CTOs)患者经皮冠状动脉介入治疗术(PCI)后不同时期右心室心肌应变及TDI指标的变化。资料与方法选择31例RCA CTOs患者,分别于术前、术后1 d及术后1个月行超声心动图检查,应用STI整体纵向应变(S)及收缩期应变率(SR)和TDI技术对右心室的等容收缩期加速度(IVA)、三尖瓣环收缩期运动幅度(TAPSE)、心肌收缩速度(SMV)、面积变化分数(FAC)值进行测量分析,并与30例健康志愿者进行比较。结果 RCA CTOs可以引起相应供血区域心肌收缩功能降低,PCI术后1 d较术前S和SR值明显增长,右心室IVA有所增长(t=-2.732、-2.634、-2.565,P<0.05);PCI术后1个月较术前S、SR及右心室IVA值均明显增长,差异均有统计学意义(t=-2.885、-2.814、-2.712,P<0.05)。而TAPSE、SMV和FAC各时期的改变均无明显差异(t=-0.254^-0.103,P>0.05)。结论 STI的S及SR和TDI的IVA可以用于评价RCA CTOs患者PCI术后右心室功能的恢复情况。Purpose To explore the changes of right ventricular strain and tissue Doppler imaging （TOI） indicators in patients with right coronary artery chronic total occlusions （RCA CTOs） after successful percutaneous coronary intervention （PCI） recanalization using two-dimensional speckle tracking imaging （2DSTI） and TOI, and to evaluate the clinical value of STI and TDl. Materials and Methods Thirty-one patients with RCA CTOs were included in this study, all the subjects underwent standard echocardiography prior and repeated one day and one month after the therapy using STI global longitudinal strain （S）, systolic strain rate （SR） and TOI to measure and analyze the right ventricular isovolumetric acceleration （IVA）, tricuspid annular plane systolic excursion （TAPSE）, myocardial systolic velocity （SMV） and fractional area change （FAC）, and the results were compared with 30 normal controls. Results Coronary chronic total occlusion could cause significant reduction of myocardial systolic function of the corresponding blood supply region, RVGLS and SR values one day after PCl were significantly higher than their preoperative values, and right ventricular IVA also showed some increment （t=-2.732, - 2.634, - 2.565; P〈0.05）; RVGLS, SR and right ventricular IVA values one month after PCI also increased significantly compared with their preoperative values, and the differences were statistically significant （t= - 2.885, - 2.814, - 2.712; P〈0.05）. There was no significant change in tricuspid annular plane systolic excursion （TAPSE）, SMV and FAC （t= -0.254- - 0.103, P〉0.05）. Conclusion Sand SR of STI and IVA ofTOl can be used to evaluate the recovery state of right ventricular function in patients with RCA CTOs after PCI.

关 键 词：冠状动脉闭塞 血管成形术 经腔 经皮冠状动脉 超声心动描记术 多普勒  彩色 斑点追踪成像 心室功能 右 

分 类 号：R541.4[医药卫生—心血管疾病] R445.1[医药卫生—内科学]