三维斑点追踪技术对无心肌梗死冠心病三支血管病变患者左心室功能的评价  

Three-dimensional speckle tracking echocardiography in evaluating left ventricular function in patients with triple vessel coronary artery disease without myocardial infarction

作　　者：崔秀秀 董彧 王颖[1] 常文星 李影 于婷婷 礼广森[1] Cui Xiuxiu;Dong Yu;Wang Ying;Chang Wenxing;Li Ying;Yu Tingting;Li Guangsen(Department of Ultrasound,the Second Affiliated Hospital of Dalian Medical University,Dalian 116027,China)

机构地区：[1]大连医科大学附属第二医院超声科,大连116027

出　　处：《中国医师杂志》2022年第5期739-744,共6页Journal of Chinese Physician

摘　　要：目的应用三维斑点追踪技术(3D-STE)评价无心肌梗死冠心病三支血管病变患者左心室的功能。方法选取2018年6月至2020年12月大连医科大学附属第二医院收治的无心肌梗死的冠心病三支血管病变患者60例,依据冠状动脉造影结果分为两组,B组31例,合并三支血管狭窄率均为50%~<75%;C组29例,合并三支血管狭窄率均≥75%,另设置健康对照30例为A组。对所有受试者行实时三维超声检查,获得左心室舒张末期容积(LVEDV)、左心室收缩末期容积(LVESV)、左心室射血分数(LVEF)。采用3D-STE获取左心室应变参数包括整体纵向应变(GLS)、整体径向应变(GRS)、整体周向应变(GCS)和整体面积应变(GAS)。Pearson线性相关分析三组3D-STE参数与N末端脑钠尿肽前体(NT-proBNP)、左室舒张末期压(LVEDP)之间的相关性。结果A、B组LVEDV及LVESV明显低于C组(均P<0.05),LVEF、GLS、GRS、GCS和GAS绝对值均高于C组(均P<0.05)。B组LVEDV、LVESV及LVEF较A组差异无统计学意义(均P>0.05),而GLS、GCS、GAS的绝对值均明显低于A组(均P<0.05)。C组GLS、GRS、GCS、GAS的绝对值与血清NT-proBNP、LVEDP均呈负相关(均P<0.05);B组GLS绝对值与NT-proBNP呈负相关(P<0.05),GLS、GRS、GCS、GAS的绝对值与LVEDP均呈负相关(均P<0.05)。结论本研究显示三维斑点追踪技术可以通过多项应变参数评价无心肌梗死冠心病三支血管病变患者左心室的功能。Objective Three-dimensional speckle tracking echocardiography(3D-STE)was used to evaluate the left ventricular function in patients with triple vessel coronary artery disease without myocardial infarction.Methods 60 patients with three vessel disease of coronary heart disease without myocardial infarction treated in the Second Affiliated Hospital of Dalian Medical University from June 2018 to December 2020 were selected.They were divided into two groups according to the results of coronary angiography.There were 31 cases in group B,and the stenosis rate of all triple vessel coronary artery was 50%-<75%;29 cases in group C,the stenosis rate of all triple vessel coronary artery was≥75%;Thirty healthy subjects were recruited as the group A.We measured left ventricular(LV)end-diastolic and end-systolic volume(LVEDV,LVESV)and LV ejection fraction(LVEF)using real-time dynamic three-dimensional echocardiography.The LV strain parameters were acquired by 3D-STE,including global longitudinal strain(GLS),global area strain,global radial strain(GRS)and global circumferential strain(GCS).The correlation between 3D-STE parameters and N-terminal proBNP(NT-proBNP),left ventricular end-diastolic pressure(LVEDP)were analyzed by Pearson linear correlation analysis.Results The LVEDV and LVESV in group A and B were significantly lower than those in group C(all P<0.05),and the absolute values of LVEF,GLS,GRS,GCS and GAS were higher than those in group C(all P<0.05).There were no significant difference in LVEDV,LVESV and LVEF between group B and group A(all P>0.05),while the absolute values of GLS,GCS and GAS in group B were significantly lower than those in group A(all P<0.05).The absolute values of GLS,GRS,GCS and GAS in group C were negatively correlated with NT-proBNP and LVEDP(all P<0.05).The absolute value of GLS in group B was negatively correlated with NT-proBNP(P<0.05),and the absolute value of GLS,GRS,GCS and GAS was negatively correlated with LVEDP(all P<0.05).Conclusions Our study shows that 3D-STE can evaluate the LV fun

关 键 词：冠心病 三维斑点追踪技术 心室功能 左 

分 类 号：R541.4[医药卫生—心血管疾病]