CABG术前超声四维心肌应变和LVEF与术后1年LVEF相关性的比较  

Comparison of Preoperative Four-dimensional Myocardial Strain and LVEF With LVEF One Year After Coronary Artery Bypass Grafting

作　　者：李丹[1] 冯杰莉[1] 张喆[2] 李昭屏[1] Li Dan;Feng Jieli;Zhang Zhe(Department of Cardiology,Institute of Vascular Medicine,Peking University Third Hospital,Beijing 100191,China;不详)

机构地区：[1]北京大学第三医院心内科、血管医学研究所,北京100191 [2]北京大学第三医院心脏外科,北京100191

出　　处：《中国微创外科杂志》2022年第2期131-136,共6页Chinese Journal of Minimally Invasive Surgery

基　　金：心血管临床研究评价平台建设《重大新药创制科技重大专项》基金(2017ZX09304012-011)。

摘　　要：目的探讨左室四维心肌应变和左室射血分数(left ventricular ejection fraction,LVEF)与冠状动脉旁路移植术(coronary artery bypass grafting,CABG)后1年LVEF的相关性。方法纳入2018年10月~2019年9月41例缺血性心肌病行CABG患者,术前行常规超声心动图检查及左室四维心肌应变成像,术后1年复查超声心动图,比较术前四维心肌应变和LVEF与术后1年LVEF的相关性。结果缺血性心肌病患者CABG术后1年LVEF较术前有明显提高[(46.63±13.68)%vs.(40.41±10.60)%,t=-5.119,P=0.000]。术前四维整体长轴应变、圆周应变、径向应变、面积应变与术后1年LVEF均具有良好相关性(r=-0.502、-0.425、0.500、-0.458),术前LVEF与术后1年LVEF也具有良好相关性(r=0.824)。以术后LVEF为主要终点评价指标,术前LVEF与CABG术后1年LVEF的相关性(r=0.824)优于术前四维心肌应变指标(r绝对值0.425~0.502)。结论缺血性心肌病患者CABG术前左室四维心肌应变与术后1年LVEF具有高度相关性,与术前LVEF结果一致。四维长轴应变与1年后LVEF相关性最高。Objective To investigate the correlation between left ventricular four-dimensional myocardial strain and left ventricular ejection fraction(LVEF)and LVEF one year after coronary artery bypass grafting(CABG).Methods A total of 41 patients with ischemic cardiomyopathy treated with CABG from October 2018 to September 2019 were included.Routine echocardiography and four-dimensional myocardial strain imaging were performed before the operation.Echocardiography was rechecked one year after the operation to study the correlation between preoperative four-dimensional myocardial strain and LVEF and LVEF one-year after operation.Results The LVEF of patients with ischemic cardiomyopathy one year after CABG was significantly higher than that before CABG[(46.63±13.68)%vs.(40.41±10.60)%,t=-5.119,P=0.000].There was a good correlation between preoperative four-dimensional global long axis strain,circumferential strain,radial strain and area strain and one-year postoperative LVEF(r=-0.502,-0.425,0.500,-0.458),and there was also a good correlation between preoperative LVEF and one-year postoperative LVEF(r=0.824).Taking the postoperative LVEF as the main endpoint evaluation index,the correlation between preoperative LVEF and one-year LVEF after CABG(r=0.824)was better than that of preoperative four-dimensional myocardial strain index(absolute correlation value 0.425-0.502).Conclusions There is a high correlation between left ventricular four-dimensional myocardial strain before CABG and LVEF one-year after CABG,which is consistent with the results of LVEF before CABG.The correlation between four-dimensional overall long axis strain and LVEF after 1 year is the highest.

关 键 词：四维心肌应变 缺血性心肌病 冠状动脉旁路移植术 左室射血分数 

分 类 号：R54[医药卫生—心血管疾病]