急性心肌梗死后心肌力学与心功能变化的相关性研究  

On the correlation between myocardial mechanics and cardiac function after acute myocardial infarction

作　　者：张爱红[1] 张建刚[1] 景江新[1] 玛依努尔.买买提明 宋鹏远[1] 吴山[2] 王霞[1] 李君[1] 塔娜[1] 

机构地区：[1]新疆医科大学第二附属医院超声科,乌鲁木齐830063 [2]首都医科大学附属北京安贞医院超声心动图一部,北京100029

出　　处：《新疆医科大学学报》2014年第11期1490-1493,共4页Journal of Xinjiang Medical University

基　　金：新疆维吾尔自治区自然科学基金(2012211A032)

摘　　要：目的探讨急性心肌梗死后各节段心肌圆周应变率(SrC)、径向应变率(SrR)及心肌扭转角度变化与左室射血分数(LVEF)的相关性。方法选取51例经冠脉造影证实的急性心肌梗死患者作为心肌梗死组,40例正常健康者作为对照组,使用二维超声斑点追踪技术分别测量心尖水平与瓣环水平左室短轴各节段心肌的圆周应变率、径向应变率、心肌扭转及LVEF指标,并分析急性心肌梗死后心肌应变率及左室扭转角度与左室射血分数的相关性。结果 (1)急性心肌梗死组患者左室容积较对照组增大,但差异无统计学意义(P>0.05);LVEF较对照组下降,差异有统计学意义(P<0.05)。(2)急性心肌梗死组患者各节段心肌SrC、SrR较对照组均明显下降,差异有统计学意义(P<0.05)。(3)急性心肌梗死组患者各节段心肌扭转角度较对照组明显下降,差异有统计学意义(P<0.05)。(4)直线相关方程显示,急性心梗组患者各节段SrC、SrR及扭转角度均与LVEF具有相关性,其中左室整体扭转角度与LVEF相关性较好(P<0.05)。结论急性心肌梗死后心肌力学发生了严重改变,其中心肌扭转较应变率对心功能的影响更为明显。Objective To investigate the correlation between left ventricular ejection fraction （LVEF）and myocardial circumferential strain,radial strain rate,myocardial torsion angle after acute myocardial infarc-tion.Methods 51 cases suffered from acute myocardial infarction and confirmed by coronary angiography were chosen as myocardial infarction group,40 healthy patients as control group.Each segment of the my-ocardial circumferential strain rate,radial strain rate,left ventricular torsion and LVEF were measured by two - dimensional ultrasound speckle tracking technology at apical level and annulus level in left ventricular short axis view respectively,then observed the relativity among myocardial circumferential strain,radial strain rate,myocardial torsion angle and left ventricular ejection fraction （LVEF）after acute myocardial infarction.Results （1）Compared with the control group,there was enlargement in the LVvolume in myocardial infarction group,but there was no statistical significance （P 〉0.05）,while there was significant decrease in LVEF in myocardial infarction group （P 〉 0.05 ）.（2）Compared with the control group,the circumferential and radial strain rate of each segment decreased significantly in myocar-dial infarction group （P〈0.05）.（3）Compared with the control group,the myocardial torsion angle of each segment decreased significantly in myocardial infarction group （P〈0.05）.（4）Linear correlation a-nalysis indicated that both strain rate and torsion angle of each segment myocardial had good correlations with LVEF,particularly presented in left ventricular torsion angle and LVEF （r =0.79 P〈0.05）.Conclu-sion After acute myocardial infarction happened,myocardial mechanics changed seriously,especially that myocardial torsion influenced cardiac function obviously.

关 键 词：急性心肌梗死 应变率 左室扭转 心功能 

分 类 号：R540.4[医药卫生—心血管疾病]