三维斑点追踪技术评价冠状动脉不同程度病变患者左房容积及功能  

Evaluation of left atrial volume and function in patients with different degrees of coronary artery lesions by three-dimensional speckle tracking imaging

作　　者：赵燕芹[1] 陈晓菲 孙品[1] 何香芹[1] 孙瑞聪 姜志荣[1] ZHAO Yanqin;CHEN Xiaofei;SUN Pin;HE Xiangqin;SUN Ruicong;JIANG Zhirong(Department of Cardiac Ultrasound,Affiliated Hospital of Qingdao University,Shandong 266000,China)

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

出　　处：《临床超声医学杂志》2022年第2期112-118,共7页Journal of Clinical Ultrasound in Medicine

基　　金：青岛市重大惠民项目(19-6-1-2nsh)。

摘　　要：目的探讨三维斑点追踪(3D-STI)技术在评价冠状动脉不同程度病变患者左房容积和功能中的价值。方法将我院确诊的81例冠状动脉粥样硬化性心脏病(以下简称冠心病)患者根据冠状动脉造影结果,按照Gensini评分标准分为轻度病变组31例(Gensini评分<25分)、中度病变组26例(25分≤Gensini评分<50分)、重度病变组24例(Gensini评分≥50分),另选同期健康体检者31例为对照组。应用3D-STI技术获取各组左房容积指数即左房最大容积指数(LAVImax)、左房最小容积指数(LAVImin)、左房主动收缩前容积指数(LAVIpre),以及左房三维整体应变参数即整体纵向、径向、圆周应变(GLS、GRS、GCS),计算左房总、被动及主动排空分数(LAEF、LApEF、LAaEF)。比较各组上述参数差异;分析左房容积指数及应变参数与Gensini评分的相关性。结果各组LAVImin、LAVIpre、LAVImax、LAEF、LApEF、LAaEF、GLS、GCS、GRS比较差异均有统计学意义(均P<0.05)。与对照组比较,轻、中、重度病变组GLS、GCS均降低(均P<0.05);与对照组和轻度病变组比较,中、重度病变组LAVImin、LAVIpre均增大,LAEF、LApEF、GLS、GCS均降低(均P<0.05);与中度病变组比较,重度病变组LAVImin、LAVIpre、LAVImax均增大,LAEF、LApEF、LAaEF、GLS、GCS、GRS均降低(均P<0.05)。LAVImin、LAVIpre与Gensini评分均呈正相关(r=0.769、0.550,均P<0.05);GCS、GLS、GRS与Gensini评分均呈负相关(r=-0.618、-0.577、-0.549,均P<0.05)。结论 3D-STI可有效评价冠状动脉不同程度病变患者左房容积及功能,为冠心病的早期发现及干预、治疗提供依据。ObjectiveTo explore the value of three-dimensional speckle tracking imaging(3 D-STI)in evaluating left atrium(LA)volume and function in patients with different degrees of coronary artery lesion.MethodsAccording to the results of coronary angiography,81 patients with confirmed coronary heart disease(CHD)were divided into mild lesion group(Gensini score<25,n=31),moderate lesion group(25≤Gensini score<50,n=26),severe lesion group(Gensini score≥50,n=24),and 31 healthy subjects at the same period were selected as control group. LA volume index including LA maximum index volume(LAVImax),LA minimum index volume(LAVImin),LA presystolic index volume(LAVIpre),and three-dimensional strain parameters of LA including global longitudinal strain(GLS),global radial strain(GRS)and global circumcircle strain(GCS)were obtained by 3 D-STI technique.LA ejection fraction,passive and active ejection fractions(LAEF,LApEF,LAaEF)were calculated. The differences of the above parameters in each group were compared. The correlation between left atrial volume index and strain parameters and Gensini score were analyzed.ResultsThere were significant differences of LAVImin,LAVIpre,LAVImax,LAEF,LApFF,LAaEF,GLS,GCS and GRS in each group(all P<0.05).Compared with the control group,GLS and GCS were decreased in the mild,moderate and severe lesion group(all P<0.05).Compared with the control group and mild lesion group,LAVImin and LAVIpre were increased,while LAEF,LApEF,GLS and GCS were decreased in the moderate and severe lesion group(all P<0.05).Compared with the moderate lesion group,the LAVImin,LAVIpre and LAVImax in the severe lesion group were increased,while LAEF,LApEF,LAaEF,GLS,GCS and GRS were decreased(all P<0.05).LAVImin and LAVIpre were positively correlated with Gensini score(r=0.769,0.550,both P<0.05),GCS,GLS,GRS were negatively correlated with Gensini score(r=-0.618,-0.577,-0.549,all P<0.05).Conclusion3 D-STI can effectively evaluate the LA volume and function in patients with different degrees of coronary artery lesions,providing e

关 键 词：超声心动描记术 斑点追踪 三维 冠状动脉粥样硬化性心脏病 GENSINI评分 心房容积 左 心肌形变 

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