斑点追踪技术评价冠心病患者PCI术前后左室心肌力学改变  

Assessment of Changes in Left Ventricular Myocardial Mechanics by Speckle Tracking Imaging in Patients with Coronary Heart Disease before and after PCI

作　　者：王翠翠[1] 薛莉[1] 梁凤梅 罗春英 李卫天 李学奇[1] 王谦谦[1] 

机构地区：[1]哈尔滨医科大学附属第四医院心内科超声室,黑龙江哈尔滨150001 [2]哈尔滨市第二医院心内科,黑龙江哈尔滨150056 [3]哈尔滨市胸科医院超声科,黑龙江哈尔滨150056

出　　处：《现代生物医学进展》2015年第16期3069-3072,共4页Progress in Modern Biomedicine

基　　金：黑龙江省教育厅科技项目(12511323)

摘　　要：目的:探讨斑点追踪成像(speckle tracking imaging,STI)技术评价经皮冠状动脉介入(percutaneous coronary intervention,PCI)术对冠状动脉严重狭窄患者左室心肌力学的改变。方法:病变组(冠状动脉左前降支狭窄>75%患者)30例,分别于PCI术前1天和术后3天、术后3个月接受超声心动图检查,测量的常规指标包括:左室射血分数(LVEF)、左室舒张末内径(LVDd)、左室舒张末容积(LVEd V),同时应用STI技术测量缺血心肌节段收缩期峰值应变参数:纵向、径向、圆周应变LS、RS、CS。体检健康者30例为对照组进行比较分析。结果:1与对照组比较,病变组PCI术前缺血心肌应变值(LS、RS、CS)均呈不同程度减低,差异均有统计学意义(P<0.05);术后3天与术前比较均无统计学差异(P>0.05);PCI术后3个月病变组LS、RS、CS较术前均不同程度提高,差异均有统计学意义(P<0.05),与对照组比较,差异无统计学意义(P>0.05);2病变组PCI术前后不同时间点与对照组比较,LVEF、LVDd、LVEd V均无统计学差异(P>0.05)。结论:STI技术可定量敏感的评价冠状动脉严重狭窄患者缺血心肌力学改变,为评价PCI术对冠心病患者的疗效提供了客观依据。Objective： To assess the efficacy of percutaneous coronary intervention（PCI） on left ventricular myocardial mechanics changes in patients with severe coronary artery stenosis using speckle tracking imaging（STI） technique. Methods： Thirty enrolled patients with left anterior descending coronary artery stenosis（〉75 %） were assigned into the lesion group, and 30 healthy volunteers were included into the control group for comparative analysis. Both groups received echocardiography 1 day before PCI, 3 days and 3 months after PCI, respectively, including routine measurements of left ventricular ejection fraction（LVEF）, left ventricular end-diastolic dimension（LVDd） and left ventricular end-diastolic volume（LVEd V）. In addition, STI technique was performed for both groups to obtain peak systolic strain parameters of longitudinal strain（LS）, radial strain（RS） and circumferential strain（CS） in the ischemia segments. Results： 1 1 day before PCI（pre-PCI）, the lesion group exhibited a significantly statistical（P 0.05） reduction in all myocardial ischemic strain values（LS, RS, CS） compared with the control group; while 3 days after PCI, compared to pre-PCI, there was no statistically significant difference（P 〈0.05）; but 3 months after PCI, a significantly increased myocardial ischemic strain value（LS,RS,CS） was observed in the lesion group compared to pre-PCI（P 〈0.05）, however, there were no statistically significant differences compared to the control group（P〉 0.05）; 2 Moreover, no statistical differences of the LVEF, LVDd and LVEd V values were found among the three time points（before and after PCI） between the lesion group and the control group（P 〉0.05）. Conclusions： STI technique can be used for quantitative and sensitive assessment of myocardial mechanics change in patients with severe coronary artery stenosis and provide the objective basis for evaluating the effect of PCI therapy on patients with coronary heart disease.

关 键 词：斑点追踪成像技术 冠心病 经皮冠状动脉介入治疗 应变 

分 类 号：R541.4[医药卫生—心血管疾病]