左心室整体纵向应变预测急性心肌梗死患者经皮冠状动脉介入术后左心室重构  

Left ventricular global longitudinal systolic strain in predicting left ventricular remodeling of acute myocardial infarction patients after percutaneous coronary intervention

作　　者：刘爽[1] 马春燕[1] 李阳[1] 杨军[1] 张立敏[1] 邹麓[2] 赵世杰[2] 

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

出　　处：《中国医学影像技术》2016年第3期363-366,共4页Chinese Journal of Medical Imaging Technology

摘　　要：目的探讨应用二维斑点追踪(STE)技术预测急性心肌梗死(AMI)患者经皮冠状动脉介入(PCI)术后左心室重构(LVR)的价值。方法对75例AMI患者于PCI术后72h及6个月行STE检查,测算左心室整体圆周应变(GCS)及整体纵向应变(GLS)。以术后6个月左心室舒张末期容积(LVEDV)≥15%作为LVR诊断标准。进行统计学分析。结果PCI术后6个月,75例中56例未发生重构(非重构组),19例发生LVR(重构组),发生率25.33%(19/75)。与术后72h比较,重构组术后6个月LVEF减低,非重构组术后6个月LVEF增高(P均<0.05)。与非重构组比较,重构组术后72h及术后6个月GCS及GLS均减低(P均<0.05)。LVEF、GCS及GLS均与LVR呈负相关(r=-0.39、-0.52、-0.64,P均<0.01)。GLS及GCS是LVR的独立预测因子。GLS的ROC曲线下面积最大,预测LVR的阈值为-12.45%,敏感度和特异度分别为86.3%及87.2%。STE参数测量观察者间差异为(9.32±3.14)%,观察者内差异为(7.18±2.26)%。结论通过STE测得的GLS可用以准确预测AMI患者PCI术后LVR。Objective To evaluate left ventricular global functions measured by speckle tracking echocardiography（STE）in predicting left ventricular remodeling（LVR）of acute myocardial infarction（AMI）patients after percutaneous coronary intervention（PCI）.Methods STE examinations were performed on 75 patients with AMI.And global left ventricular longitudinal systolic strain（GLS）and circumferential strain（GCS）were measured within 72 hours and 6months after PCI.An increase of more than or equal to 15%in left ventricular end diastolic volume after 6months was the standard for LVR diagnosis.Statistic analysis was performed.Results There were 19 patients with LVR（LVR group）and 56 patients without LVR（non-LVR group）.The incidence of LVR after 6months was 25.33%（19/75）.Compared with 72 hafter PCI,the LVEF of 6monthes after PCI in LVR group decreased,while that in non-LVR group increased（both P〈0.05）.Compared with non-LVR group,GCS and GLS decreased in LVR group 72 hand 6months after PCI（all P〈0.05）.LVEF,GCS and GLS were negatively correlated to LVR（r=-0.39,-0.52,-0.64,all P〈0.01）.GLS and GCS were the independent predictors of LVR.The area under the curve（AUC）of GLS was the largest.The optimal GLS cut-off for predicting adverse LVR was-12.45% with sensitivity of 86.3%and specificity of 87.2%.The inter-and intra-observer variability of STE parameters was（9.32±3.14）%and（7.18±2.26）%,respectively.Conclusion GLS evaluated by STE can be used to predict the LVR in AMI patients after PCI.

关 键 词：超声心动描记术 急性心肌梗死 左心室重构 

分 类 号：R542.2[医药卫生—心血管疾病] R540.45[医药卫生—内科学]