二维斑点追踪成像技术评价不同部位冠状动脉病变患者左室心肌的扭转运动  

Study on left ventricular rotation and twist by two-dimensional speckle tracking imaging in patients with coronary artery disease

作　　者：荆纪英[1] 章蓉[1] 李荣[1] 董来君 朱艳[1] 孙冬梅[1] 吴燕[1] 

机构地区：[1]青岛大学附属医院心脏超声科,山东省青岛市266000 [2]青岛市城阳区人民医院超声科

出　　处：《临床超声医学杂志》2016年第4期225-228,共4页Journal of Clinical Ultrasound in Medicine

摘　　要：目的应用二维斑点追踪成像(2D-STI)技术评价静息状态下不同部位冠状动脉病变患者左室扭转运动的特点。方法 45例冠状动脉粥样硬化性心脏病患者根据冠状动脉造影结果分为单纯左前降支病变组(LAD组)25例和单纯右冠状动脉病变组(RCA组)20例,同期心脏无异常者35例为对照组。所有患者均采集左室心尖和心底短轴二维图像,记录收缩期心内膜旋转角度峰值(Rendo)、心外膜旋转角度峰值(Repi)、切面整体旋转角度峰值(Rbulk)、跨壁扭转角度梯度(Tmural)及达峰时间。计算各切面整体旋转解旋率(Untw R)。将基底水平和心尖水平数据录入表格,计算左室整体扭转角度峰值(Ptw-bulk)和达峰时间。结果 1与对照组比较,LAD组心尖水平Rendo、Repi、Rbulk及Tmural均明显减低(均P<0.01),达峰时间延迟(P<0.05),Untw R减低(P<0.05);2与对照组比较,RCA组基底水平Rendo、Repi、Rbulk及Tmural均明显减低(均P<0.01),达峰时间延迟(P<0.05),Untw R减低(P<0.05);3LAD组与RCA组比较,Ptw-bulk和达峰时间差异无统计学意义;4Rendo、Repi、Rbulk及Ptw-bulk均与LVEF呈正相关,Ptw-bulk与LVEF相关性最佳(r=0.68,P<0.01),其次为心尖水平Rbulk(r=0.43,P<0.01),Tmural与LVEF不相关。结论不同部位冠状动脉病变能够引起左室心肌相应节段旋转及扭转减低,左室整体扭转与左室收缩功能密切相关,应用2D-STI技术可以评价不同部位冠状动脉病变患者的左室心肌扭转运动。Objective To evaluate left ventricular rotation and twist in patients with coronary artery disease at rest by two-dimensional speckle tracking imaging（2D-STI）. Methods Forty-five coronary artery disease patients and 35 healthy volunteers（control group） were included in the study. According to the result of selective coronary angiography, 45 patients were divided in two groups：LAD group（n=25） and RCA group（n=20）. Short-axis parasternal views were taken at the base and the apex of the heart. 2D-STI was applied to analyze the rotation curves at apex and base,the Rendo,Repi,Rbulk,Tmural and the time to peak was recorded. And then,UntwR,Ptw-bulk and the time to peak were calculated. Results ①Compared with the control group, Rendo,Repi,Rbulk,Tmural and UntwR decreased significantly and the time to peak were delayed in apical level in LAD group（all P〈0.05）.②Compared with the control group, Rendo,Repi, Rbulk,Tmural and UntwR decreased significantly and the time to peak were delayed in basal level in RCA group （all P〈0.05）. ③For Ptw-bulk and the time to peak,there was no significant difference between LAD group and RCA group. ④Rendo,Repi,Rbulk and Ptw-bulk were positively related to LVEF. Furthermore,Ptw-bulk had the highest relation to LVEF（r=0.68,P〈0.01）,followed by Rbulk of the apical level（r=0.43,P〈0.01）. But Tmural was not related to LVEF. Conclusion Left ventricular twist is related to LVEF. Left ventricular twist and coronary artery stenosis at different segment can be evaluated by 2D-STI.

关 键 词：斑点追踪成像 二维 冠状动脉 扭转 心室 左 

分 类 号：R541.4[医药卫生—心血管疾病] R540.45[医药卫生—内科学]