二维斑点追踪技术评价不同程度冠状动脉狭窄患者心肌应变改变  

Evaluation of Myocardial Strain in Patients with Different Severity Coronary Stenosis by 2D Speckle Tracking Imaging

作　　者：张妍[1] 马春燕[1] 刘爽[1] 关正宇[1] 王永槐[1] 邹麓[2] 杨军[1] 

机构地区：[1]中国医科大学附属第一医院心血管超声科,沈阳市110001 [2]中国医科大学附属第一医院心内科,沈阳市110001

出　　处：《中国超声医学杂志》2014年第3期223-226,共4页Chinese Journal of Ultrasound in Medicine

基　　金：辽宁省科技厅科学计划项目(No.2011225020)

摘　　要：目的采用二维斑点追踪技术（speckletrackingimaging，STI）评价不同程度冠状动脉狭窄患者心肌应变改变。方法对75例可疑冠心病患者进行超声心动图检查，根据冠状动脉造影结果，将不同程度狭窄的冠状动脉支配心肌分为：冠脉正常组、轻度狭窄组、中度狭窄组和重度狭窄组（O％、〈50％、50％～69％和70％～99％）。测量心肌纵向应变（10ngitu—diaalstrain，I。S）、径向应变（radialstrain，RS）及圆周应变（circumferentialstrain，CS）。结果轻度狭窄组LS、RS和CS无明显改变，中度狭窄组仅LS减低（P〈0．05），重度狭窄组LS、RS和CS均减低（P〈0．001）。LS为-17．29％诊断冠状动脉中度狭窄的灵敏度及特异度分别为53．8％和54．1％（Auc-0．54，P〈0．05）；LS为-16．34％诊断冠状动脉重度狭窄的灵敏度及特异度分别为78．3％和82．0％（AUC=0．82，P〈0．001）。结论冠状动脉狭窄程度〉50％时，其支配心肌收缩功能已减低，纵向应变可准确评价不同程度冠状动脉狭窄患者心肌功能改变。Objective To investigate the myocardial strain in patients with different severity of coronary stenosis by two-dimensional speckle tracking imaging （STI）. Methods 75 patients with suspected coronary heart disease un- derwent STI and coronary CT angiography （CCTA）. According to the results of CCTA,the myocardial segment were divided into normal group, mild stenosis group, moderate stenosis group and severe stenosis group. LS, RS, and CS were measured by STI. Results LS , RS and CS of mild stenosis group had no difference compared with those of nor- mal group（P〈0.05）. Only LS of moderate stenosis group were decreased compared with those of normal group（P〈 0.05）, LS, RS and CS of severe stenosis group were significantly decreased compared with those of normal group （P〈 0. 001）. The sensitivity and specificity of LS in diagnosis of moderate stenosis of coronary artery were 53.8% and 54.1%, respectively, with cut-off value of -17.29% （area uniter ROC curve[AUC]=0.54, P〈0.05）, and those were 78.3% and 82.0% in predicting of severe stenosis of coronary artery, with cut-off value of -16.34% （AUC= 0.82, P%0. 001）. Conclusions The systolic function of myoeardium subtended by〉50% coronary stenosis was im paired in patients with CHD. LS can accurately evaluate the myocardial function in patients with different severity of coronary stenosis.

关 键 词：斑点追踪技术 纵向应变 冠状动脉狭窄 

分 类 号：R541.4[医药卫生—心血管疾病]