实时三维超声心动图诊断节段性室壁运动异常冠心病患者临床价值研究  

Clinical value of RT-3DE in coronary heart disease patients with segmental ventricular wall movement abnormalities

作　　者：宿海峰 裴娟慧[1] 甘丰[1] 崔丽萍[2] 郭艳[2] SU Haifeng;PEI Juanhui;GAN Feng;CUI Liping;GUO Yan(Department of Cardiology,Beijing Aerospace General Hospital,Beijing 100760,China;不详)

机构地区：[1]北京航天总医院心内科,北京100760 [2]解放军总医院第二医学中心心内科,北京100036

出　　处：《陕西医学杂志》2023年第7期822-825,830,共5页Shaanxi Medical Journal

基　　金：国家自然科学基金资助面上项目(81370287);北京市首都卫生发展基金资助项目(SF2018-4-5013)。

摘　　要：目的:探究实时三维超声心动图(RT-3DE)在冠心病节段性室壁运动异常患者动脉病变的临床价值。方法:选取接受冠状动脉造影检查的有明显节段性左室壁运动异常的冠心病患者100例为观察组;另选择同期100例冠脉造影正常者为对照组,两组均进行心脏RT-3DE检查分析,比较两组左室收缩末容积(LVESV)、左心室舒张末容积(LVEDV)、左心室射血分数(LVEF)、左心室心肌质量(LVM)、左心室重构指数(LVRI)数值,以及整体心功能参数,并对图像采用定量分析软件进行处理和分析。结果:与对照组比较,观察组患者的左心室基底段、中间段的局部舒张期末期容积(REDV)、局部收缩末期容积(RESV)均较高(均P<0.05)。与对照组比较,RT-3DE检测的观察组(单只、双只、多只病变)整体心功能参数LVEDV、LVESV升高,LVEF、LVRI降低(均P<0.05),两组LVM比较无统计学差异(P>0.05)。对照组左心室容积-时间曲线(VTC)排列有序,各节段曲线形态一致,各曲线的波峰、波谷的横坐标位置接近,时间牛眼图上左室整体达收缩末期时间相近为绿色,位移牛眼图上运动正常为蓝色;观察组病变区域VTC形态不规则、杂乱,曲线的波峰、波谷后移,时间牛眼图上为红色,其周围节段出现蓝色、绿色,位移牛眼图上为黑色。受试者工作体征曲线(ROC曲线)结果显示,RT-3DE在冠心病节段性室壁运动异常患者冠状动脉病变检测的灵敏性为68.59%,特异度为85.72%,曲线下面积(AUC)值为0.866。结论:RT-3DE可分析评估冠心病患者节段性室壁运动异常,并可对冠状动脉病变进行定量分析,在临床检测中具有较高的应用价值。Objective:To explore the clinical value of RT-3DE in coronary artery disease patients with segmental ventricular wall movement abnormalities.Methods:A total of 100 patients with coronary heart disease and significant segmental left ventricular wall motion abnormalities who underwent coronary angiography were selected as the observation group.Another 100 patients with normal coronary angiography in the same period were selected as the control group.RT-3DE was performed in both groups to compare the values of ventricular end-systolic volume(LVESV),left ventricular end-diastolic volume(LVEDV),left ventricular ejection fraction(LVEF),left ventricular myocardial mass(LVM),left ventricular remodeling index(LVRI)and overall cardiac function parameters,and the image was processed and analyzed by quantitative analysis software.Results:Compared with the control group,the local REDV and RESV of the basal and middle segments of the left ventricle in the observation group were higher(all P<0.05).Compared with the control group,the cardiac function parameters LVEDV and LVESV were increased,and LVEF and LVRI were decreased in the observation group(single,double and multiple animals)detected by RT-3DE(all P<0.05),and there was no difference in LVM between the two groups(P>0.05).The left ventricular volume-time curve of the control group was arranged in anorderly manner,and the curve shape of each segment was consistent.The horizontal coordinates of the peaks and valleys of each curve were close.The end time of the overall contraction of the left ventricle on the time bull’s eye diagram was similar to green,and the movement on the displacement bull.ROC curve results showed that the sensitivity,specificity and AUC value of RT-3DE were 68.59%,85.72%and 0.866 in the detection of arterial lesions in coronary heart disease patients with abnormal segmental wall motion.Conclusion:RT-3DE can be used to analyze and evaluate the abnormal segmental wall motion in patients with coronary heart disease,and to quantitatively analyze the arter

关 键 词：冠心病 节段性室壁运动异常 实时三维超声心动图 诊断 整体心功能参数 

分 类 号：R540.4[医药卫生—心血管疾病]