斑点追踪技术评价冠状动脉慢血流患者左心室纵向收缩功能  

Evaluation of left ventricular longitudinal systolic function in patients with coronary artery slow flow by speckle tracing

作　　者：李琳[1] 孙俊杰[1] 王丽红[1] LI Lin;SUN Junjie;WANG Lihong(Department of Ultrasound,Yantai Yuhuangding Hospital,Yantai 264000,China)

机构地区：[1]山东省烟台毓璜顶医院超声科,山东烟台264000

出　　处：《医学影像学杂志》2023年第11期1985-1988,共4页Journal of Medical Imaging

基　　金：山东省医药卫生科技发展计划项目(编号:202009021002)。

摘　　要：目的探讨二维斑点追踪技术(2D-STE)评价平板运动负荷前后冠状动脉慢血流(Coronary slow flow,CSF)患者左心室纵向收缩功能的变化,为临床提供可靠的信息。方法选取临床诊断CSF患者33例(CSF组)及冠状动脉造影检查结果正常者30例(对照组),分别在静息状态和运动负荷后,采集左心室长轴、心尖四腔及心尖两腔动态二维图像,计算两组左心室收缩末期的内径(LVEDS)、左心室舒张末期的内径(LVEDD),左心室舒张末期的容积(LVEDV)、左心室射血分数(LVEF)、左心室整体纵向应变(GSL)及负荷前后GLS变化幅度(ΔGLS)。结果静息状态下:两组LVEDD、LVESD、LVEDV、LVEF差异均无统计学意义(P>0.05),两组GLS差异有统计学意义(P<0.001);两组负荷LVEF均较静息状态下明显升高(P<0.01),但是两组间比较差异无统计学意义(P>0.05);两组的负荷GLS均较静息状态明显升高,且两组间差异有统计学意义(P<0.01),对照组的静息状态下及负荷峰值状态下左心室GLS均大于CSF组。结论静息状态下,CSF患者左心室纵向收缩功能减低;运动负荷状态下,CSF患者左心室纵向收缩显著改善;左心室心肌纵向应变值GLS能早期识别CSF患者的心肌纵向收缩功能的细微变化,为临床提供可靠的诊疗价值。Objective To evaluate the changes of left ventricular systolic function in patients with coronary slow flow(CSF)before and after treadmill exercise load by two-dimensional speckle tracking technology(2D-STE),so as to provide reliable information for the clinic.Methods 33 cases of CSF diagoned in clinic(study group)and 30 cases in the control group(with normal coronary angiography results)were selected.After the static state and exercise load state,dynamic two-dimensional images of three views(left ventricular longaxis,apical four chambers and apical two chambers)were collected to calculate the left ventricular end-systolic inner diameter(LVEDS),Left ventricular end-diastolic inner diameter(LVEDD),leftventricular end-diastolic volume(LVEDV),left ventricular ejection fraction(LVEF),left ventricular global longitudinal strain(GSL),and GLS change amplitude before and after load(ΔGLS).Results At static state,there was no statistically significant difference in LVEDD,LVESD,LVEDV,LVEF between the two groups(P>0.05),and the difference in GLS between the two groups was statistically significant(P<0.001);The LVEF of both groups was significantly higher than that of the resting state.(P<0.01),but the difference between the two groups was not statistically significant(P>0.05);The GLS of both groups was significantly higher than that of restingstate(P<0.01),and the difference between the two groups was statistically significant.The left ventricular GLS in the static state and the peak load state of the control group was greater than that of the CSF group.Conclusion At the static state,the longitudinal systolic function of the left ventricle is reduced in patients with CSF;the longitudinal contraction of the left ventricle in CSF patients is significantly improved under exercise load;the longitudinal strain value of the left ventricular myocardium,GLS can early identify subtle changes in the longitudinal systolic function of the myocardium in CSF patients,which provids reliable source for clinically diagnosis and treatment.

关 键 词：冠状动脉慢血流 二维斑点追踪 心室功能 超声检查 

分 类 号：R541[医药卫生—心血管疾病] R445.1[医药卫生—内科学]