速度向量成像定量评价冠心病患者左室心肌收缩功能  

The quantitative assessment of left ventricular local myocardial systolic function in patients with coronary heart disease by velocity vector imaging

作　　者：观志强[1] 姚怀齐[1] 王帆[1] 郑宝群[1] 陈畅[1] 

机构地区：[1]汕头大学医学院第一附属医院超声科,广东省汕头515041

出　　处：《中国医师杂志》2016年第6期833-836,共4页Journal of Chinese Physician

基　　金：广东省省级科技计划项目（2014A0202124t4）

摘　　要：目的探讨速度向量成像（VVI）的收缩期应变率（SRs）参数评价冠心病患者左室心肌收缩功能的应用价值。方法临床怀疑冠心病患者共86例，先行普通超声检查，再用VVI检测，显示整体射血分数（EF）及收缩期左室局部心肌参数：心尖二、三、四腔心切面整体纵向心内膜收缩期应变率（A2-GLSRs、A3-GLSRs、A4-GLSRs），二尖瓣、乳头肌、心尖短轴切面整体径向心内膜收缩期应变率（MV—GRSRs、PM-GRSRs、AP-GRSRs），二尖瓣、乳头肌、心尖短轴切面整体圆周心内膜收缩应变率（MV—GCSRs、PM-GCSRs、AP-GCSRs）；后行冠脉造影检查，将符合条件患者分为对照组（造影结果正常）、冠状动脉粥样硬化组（造影结果狭窄〈50％）和冠心病组（造影结果狭窄I〉50％）。比较各组间各参数差别。结果所有受试者具有正常LVEF，且三组间LVEF比较差异无统计学意义（P〉0．05）。对照组E／A比值显著高于冠状动脉粥样硬化组和冠心病组（P〈0．05）。冠心病组左室各切面整体纵向、径向、圆周心内膜收缩期应变率参数明显低于冠状动脉粥样硬化组和对照组（均P〈0．05）。冠状动脉粥样硬化组的MV—GCSRs低于对照组[（-1．12±0．42）／s vs（-1．37±0．25）／s]，差异有统计学意义（P〈0．01），其他左室各切面整体纵向、径向、圆周心内膜收缩期应变率参数差异无统计学意义（P〉0．05）。结论VVI的左室各切面整体纵向、径向、圆周心内膜SRs对评价冠心病患者左室心肌收缩功能有很好的临床诊断价值。MV-GCSRs是评价冠状动脉粥样硬化患者（冠状动脉狭窄〈50％）左室收缩期局部心肌功能价值较高的参数，具有一定早期诊断的临床价值。Objective To explore the preliminarily clinical value of strain rate parameters using velocity vector imaging （VVI） evaluating left ventricular regional endocardial systolic function in patients with coronary artery heart disease （CAD）. Methods A total of eight six inner subjects who were suspected as CAD was enrolled in the study. Patients with the vascular stenosis rate ≥ 50% were defined as the CAD group, patients with the vascular stenosis rate 〈 50% were defined as the coronary atherosclerosis group, and patients with the completely normal angiographic results were included in the control group, according to the results of angiography. The left ventricular endocardial systolic strain rate parameters of VVI were obtained in standard long axis views （ apical two, three, and fourchamber view） and short axis views （ at the level of the mitral valve, papillary muscles, and apex）. The strain rate parameters were global longitudinal endocardial systolic strain rate in the apical two, three, and four - chamber views （ A2.GLSRs, A3- GI-SRs, and A4-GLSRs）, global radial endocardial systolic strain rate in short axis view of the mitral valve level, papillary muscles, and apex （MV-GRSRs, PM-GRSRs, and AP-GRSRs）, and global circumferential endocardial systolic strain rate in short axis view of the mitral valve level, papillary muscles, and apex （MV-GCSRs, PM-GCSRs, and AP-GCSRs）. The parametric differences were compared among three groups.Results All the subjects included in the present study had normal left ventricular ejection fraction （LVEF） and there was no significant difference in LVEF across three groups. Compared to other groups, the control group had significantly higher E/A ratio. The LV endocardial systolic strain rate parameters were all significantly reduced in the CAD group compared to the control group and the coronary atherosclerosis group （all P 〈 0. 05 ）. Compared to the control group[ （ -1.37 ± 0. 25）/s], the coronary atherosclerosis group （ -1.12± 0.4

关 键 词：超声心动描记术 冠心病/超声检查 

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