三维斑点追踪技术评估急性心肌梗死经皮冠状动脉介入术后左室重构患者心肌功能的价值  

Evaluation of myocardial function in left ventricular remodeling patients with acute myocardial infarction after percutaneous coronary intervention by three-dimensional speckle tracking technique

作　　者：朱俊益 陈磊[1] 王玲娟 ZHU Junyi;CHEN Lei;WANG Lingjuan(Department of Ultrasound,Gusu School,Nanjing Medical University,the Affiliated Suzhou Hospital of Nanjing Medical University,Jiangsu 215007,China)

机构地区：[1]南京医科大学姑苏学院,南京医科大学附属苏州医院,苏州市立医院超声科,江苏省苏州市215007

出　　处：《临床超声医学杂志》2022年第12期920-924,共5页Journal of Clinical Ultrasound in Medicine

摘　　要：目的 探讨三维斑点追踪(3D-STI)技术在急性心肌梗死(AMI)经皮冠状动脉介入(PCI)术后左室重构(LVR)患者心肌功能评估中的临床价值。方法 选取我院收治的73例AMI患者,根据PCI术后6个月LVR情况分为LVR组23例和非LVR组50例,另选取同期体检健康者30例为对照组,各组均行二维超声心动图和3D-STI检查,获得左室舒张末期内径(LVIDd)、室间隔厚度(IVSd)、左室后壁厚度(LVPWd)、左室射血分数(LVEF)、二尖瓣口舒张早期和晚期峰值流速(E、A)、二尖瓣环舒张早期峰值速度(e’)、整体纵向应变(GLS)、整体径向应变(GRS)、整体圆周应变(GCS)、整体面积应变(GAS)、左室整体扭转角度峰值(LVtw)、左室基底平面各节段扭转角度峰值(Ptw-B)、心尖平面各节段扭转角度峰值(Ptw-A),以及左室整体做功指数(GWI)、整体做功效率(GWE)、整体有用功(GCW)、整体无用功(GWW),比较各组间上述参数的差异。结果 二维超声心动图检查结果显示,LVR组LVIDd、IVSd、LVPWd、E/A、E/e’均高于非LVR组,LVEF、E、A均低于非LVR组,差异均有统计学意义(均P<0.05)。与对照组比较,LVR组和非LVR组LVIDd、IVSd、LVPWd、E/A、E/e’均升高,LVEF和A均降低,差异均有统计学意义(均P<0.05)。3D-STI检查结果显示,LVR组和非LVR组GLS、GRS、GCS、GAS均低于对照组,且LVR组各参数均低于非LVR组,差异均有统计学意义(均P<0.05)。与对照组比较,LVR组LVtw、Ptw-B、Ptw-A、GWI、GCW、GWW、GWE均降低,非LVR组Ptw-B、LVtw、GWI、GCW、GWW、GWE均降低,差异均有统计学意义(均P<0.05)。与LVR组比较,非LVR组GWI、GCW、GWW、GWE均升高,差异均有统计学意义(均P<0.05)。结论 3D-STI技术有助于临床评估AMI患者PCI术后LVR发生情况,具有较好的临床应用价值。Objective To explore the clinical value of three-dimensional speckle tracking imaging(3D-STI)in the evalution of myocardial function in left ventricular remodeling(LVR)patients with acute myocardial infarction(AMI)after percutaneous coronary intervention(PCI).Methods A total of 73 AMI patients admitted to our hospital were selected.They were divided into LVR group(n=23)and non-LVR(NLVR)group(n=50)according to the LVR at 6 months after PCI.Another30 healthy subjects during the same period were selected as the control group.Two-dimensional echocardiography and 3DSTI were performed in each group.The left ventricular end-diastolic diameter(LVIDd),interventricular septum thickness at diastole(IVSd),left ventricular posterior wall thickness at diastole(LVPWd),left ventricular ejection fraction(LVEF),early and late peak mitral valve orifice velocity(E,A),early diastolic peak mitral annular velocity(e’),global longitudinal strain(GLS),global radial strain(GRS),global circumferential strain(GCS),global area strain(GAS),left ventricular global twist(LVtw),peak basal twist at each segment of the LV basal plane(Ptw-B),peak apical twist at each segment of the LV apical plane(Ptw-A),and left ventricular global work index GWI,global work efficiency(GWE),global constructive work(GCW),global wasted work(GWW)were obtained.The differences of the above parameters among the groups were compared.Results Twodimensional echocardiography showed that LVIDd,IVSd,LVPWd,E/A and E/e’in LVR group were higher than those in NLVR group,while LVEF,E and A were lower than those in NLVR group,and the differences were statistically significant(all P<0.05).Compared with the control group,LVIDd,IVSd,LVPWd,E/A,E/e’in LVR group and NLVR group were increased,while LVEF and A were decreased,and the differences were statistically significant(all P<0.05).3D-STI showed that GLS,GRS,GCS and GAS in LVR group and NLVR group were lower than those in control group,and all parameters in LVR group were lower than those in NLVR group,the differences were statis

关 键 词：超声心动描记术 斑点追踪 三维 心肌梗死 急性 经皮冠状动脉介入 心室重构 心肌功能 

分 类 号：R540.45[医药卫生—心血管疾病]