左室压力-应变环技术评估急性ST段抬高型心肌梗死患者左心功能及左室重构的价值  

Value of left ventricular pressure-strain loop in evaluating left ventricular function and remodeling in patients with ST-segment elevation myocardial infarction

作　　者：刘裴[1] 杨蓉 LIU Pei;YANG Rong(Department of Ultrasound Diagnosis,the NO.4 People’s Hospital of Hengshui,Hebei 053000,China;不详)

机构地区：[1]河北省衡水市第四人民医院超声诊断科,053000 [2]河北省医科大学第二附属医院心脏内科

出　　处：《临床超声医学杂志》2023年第6期436-440,共5页Journal of Clinical Ultrasound in Medicine

基　　金：河北卫生健康委重点科技研究项目(20190557)。

摘　　要：目的探讨左室压力-应变环(LV-PSL)技术评估急性ST段抬高型心肌梗死(STEMI)患者经皮冠状动脉介入(PCI)术后左心功能及左室重构的临床价值。方法选取我院收治的90例STEMI患者(观察组)和同期体检的健康成人90例(对照组),比较对照组和观察组术前及术后3 d常规超声心动图指标、左室整体纵向应变(GLS),以及左室心肌做功指标,包括整体有效功(GCW)、整体做功效率(GWE)、整体做功指数(GWI)、整体有效做功(GCW)的差异。进一步将STEMI患者分为单支冠状动脉狭窄组61例与多支冠状动脉狭窄组29例,比较两组上述指标的差异。应用Spearman相关分析法分析左室心肌做功指标与常规超声心动图指标、GLS的相关性。结果观察组术前及术后3 d左室收缩末期容积(LVESV)、左室舒张末期容积(LVEDV)、GWW均高于对照组,左室射血分数(LVEF)、GLS、GWE、GWI、GCW均低于对照组,差异均有统计学意义(均P<0.05)。观察组术后3 d LVEDV、LVESV、GWW均低于术前,LVEF、GLS、GWE、GCW、GWI均高于术前,差异均有统计学意义(均P<0.05)。多支冠状动脉狭窄组术前及术后3 d LVEDV、LVESV、GWW均高于单支冠状动脉狭窄组,LVEF、GLS、GWE、GWI、GCW均低于单支冠状动脉狭窄组,差异均有统计学意义(均P<0.05)。相关性分析显示,GWW与GLS、LVEF均呈负相关,GWE、GCW、GWI与GLS、LVEF均呈正相关(均P<0.001)。结论LV-PSL技术在评估STEMI患者PCI术后左心功能及左室重构中具有较好的临床应用价值。Objective To investigate the clinical value of left ventricular pressure-strain loop(LV-PSL)in evaluating left ventricular function and remodeling in patients with acute ST-segment elevation myocardial infarction(STEMI)after percutaneous coronary intervention(PCI).Methods Ninety patients with STEMI admitted to our hospital(observation group)and 90 healthy adults who underwent physical examination during the same period(control group)were selected.The conventional echocardiographic indexes,left ventricular global longitudinal strain(GLS)and left ventricular myocardial work indexes[global work efficiency(GWE),global work index(GWI),and global constructive work(GCW)]were detected before and 3 d after surgery.The differences of the above indexes between the observation and control groups were compared.STEMI patients were further divided into single-branch coronary artery stenosis group(61 cases)and multi-branch coronary artery stenosis group(29 cases),the differences of the above indexes between the two groups were compared.Spearman correlation analysis was used to analyze the correlation between left ventricular myocardial work indexes and conventional echocardiographic indexes,GLS.Results The left ventricular end-systolic volume(LVESV),left ventricular end-diastolic volume(LVEDV)andGWW in the observation group were higher than those in the control group before and 3 d after surgery,while the left ventricular ejection fraction(LVEF),GLS,GWE,GWI and GCW were lower than those in the control group,with statistical significances(all P<0.05).At 3 d after surgery,LVEDV,LVESV and GWW in the observation group were lower than those before surgery,while LVEF,GLS,GWE,GCW and GWI were higher than those before surgery,with statistical significances(all P<0.05).LVEDV,LVESV and GWW at 3 d before and after surgery in the multi-branch coronary artery stenosis group were higher than those in the single-branch coronary artery stenosis group,while LVEF,GLS,GWE,GCW and GWI were lower than those in the single-branch coronary artery steno

关 键 词：超声心动描记术 左室压力-应变环 急性ST段抬高型心肌梗死 左室重构 左心功能 

分 类 号：R540.45[医药卫生—心血管疾病]