三维斑点追踪超声心动图在评估老年冠心病患者左心房功能及预后中的应用  

Application of three-dimensional speckle tracking echocardiography in the evaluation of left atrial function and prognosis in elderly patients with coronary heart disease

作　　者：李梦梅 宋弯弯 Li Mengmei;Song Wanwan(Department of Cardiovascular Ultrasound,Zhongnan Hospital of Wuhan University,Wuhan 430000,China)

机构地区：[1]武汉大学中南医院心血管超声医学科,武汉430000

出　　处：《临床内科杂志》2024年第9期618-622,共5页Journal of Clinical Internal Medicine

摘　　要：目的 分析三维斑点追踪超声心动图(3D-STE)在老年冠心病(CHD)患者左心房功能及预后评估中的应用价值。方法 回顾性选取2020年3月~2022年9月我院收治的老年CHD患者60例,根据随访结果将其分为主要心血管不良事件(MACE)组(22例)和非MACE组(38例)。比较两组患者基线资料和3D-STE左心房结构参数[舒张末期左心房最小容积(LAVmin)、左心房收缩前容积(LAVp)、收缩末期左心房最大容积(LAVmax)]、功能参数[左心房排空分数(LAEF)、左心房主动排空分数(LAAEF)、左心房被动排空分数(LAPEF)]和应变参数[左心房存储期应变(LASr)、左心房收缩期应变(LASct)和左心房管道期应变(LAScd)]。采用多因素logistic回归分析评估老年CHD患者发生MACE的危险因素;采用受试者工作特征(ROC)曲线分析LAVmin和LAEF对其发生MACE的预测效能。结果 MACE组患者LAVmin显著大于非MACE组,而LAEF明显小于非MACE组(P<0.05)。多因素logistic回归分析结果显示,LAVmin、LAEF均是老年CHD患者发生MACE的独立危险因素(P<0.05)。ROC曲线分析结果显示,LAVmin联合LAEF预测老年CHD患者发生MACE的曲线下面积(AUC)显著高于二者单独预测(Z=3.058、2.650,P=0.002、0.006)。结论 3D-STE可用于评估老年CHD患者左心房功能及预后,LAVmin、LAEF与老年CHD患者发生MACE密切相关,且二者联合检测效能更高。Objective To analyze the application value of three-dimensional speckle tracking echocardiography(3D-STE) in the evaluation of left atrial function and prognosis in elderly patients with coronary heart disease(CHD).Methods A total of 60 elderly patients with CHD who were admitted to the hospital from March 2020 to September 2022 were retrospective enrolled and divided into major cardiovascular adverse event(MACE) group(22 cases) and non-MACE group(38 cases) according to follow-up results.Baseline data,left atrial structure,function and strain parameters [end diastolic minimum left atrial volume(LAVmin),left atrial volume just before left atrium contraction(LAVp),end systolic maximal left atrial volume(LAVmax),left atrial emptying fraction(LAEF),left atrial active emptying fraction(LAAEF),left atrial passive emptying fraction(LAPEF),left atrial storage strain(LASr),left atrial contractile strain(LASct) and left atrial conduit strain(LAScd)] measured by 3D-STE were compared between the two groups.Multivariate logistic regression analysis was conducted to screen the risk factors for MACE in elderly patients with CHD.Receiver operating characteristic(ROC) curves were used to analyze the predictive efficacy of LAVmin and LAEF for the occurrence of MACE.Results LAVmin of MACE group was significantly larger than that of non-MACE group and LAEF was significantly lower than that of non-MACE group(P<0.05).Multivariate logistic regression analysis showed that LAVmin and LAEF were independent risk factors for MACE in elderly patients with CHD(P<0.05).ROC curve analysis results showed that the area under the curve(AUC) of LAVmin combined with LAEF for predicting MACE in elderly patients with CHD was significantly larger than that of prediction with a single parameter(Z=3.058,2.650,P=0.002,0.006).Conclusion 3D-STE can be used to evaluate left atrial function and prognosis in elderly patients with CHD.LAVmin and LAEF are closely related to the occurrence of MACE in elderly patients with CHD,and joint detection of the two can ac

关 键 词：三维斑点追踪超声心动图 冠心病 老年患者 左心房功能 预后 

分 类 号：R541.4[医药卫生—心血管疾病]