超声心动图定量评估心肌做功参数与冠状动脉狭窄程度相关性的研究  

Study of association between quantitative assessment of echocardiography and coronary artery disease

作　　者：邢彦麟 王子健 裴娟慧[1] 白云鹤 任格 甘丰[1] Xing Yanlin;Wang Zijian;Pei Juanhui;Bai Yunhe;Ren Ge;Gan Feng(Department of Cardiology,Beijing Aerospace General Hospital,Beijing 100076,China)

机构地区：[1]北京航天总医院心血管内一科,北京100076

出　　处：《中国医刊》2025年第1期23-27,共5页Chinese Journal of Medicine

摘　　要：目的探究冠状动脉狭窄严重程度与超声心动图定量评估心肌做功(MW)参数的相关性。方法选择2021年6月至2023年6月于北京航天总医院就诊的122例冠状动脉粥样硬化性心脏病患者为研究对象,根据冠状动脉造影(CAG)诊断冠状动脉狭窄程度的结果,将患者分为重度狭窄组(狭窄>75%,41例)、中度狭窄组(狭窄50%~75%,40例)和对照组(狭窄<50%,41例)。所有患者均接受经胸超声心动图、二维斑点追踪超声心动图(STE)检查,分析二维左心室整体纵向应变(GLS)及MW参数,绘制受试者操作特征(ROC)曲线,评估MW参数对冠状动脉病变狭窄程度的诊断效能。结果对照组整体做功指数(GWI)、整体做功效率(GWE)、整体有用功(GCW)均高于重度狭窄组和中度狭窄组,且中度狭窄组高于重度狭窄组(P<0.05);对照组整体无用功(GWW)低于中度狭窄组和重度狭窄组,且中度狭窄组低于重度狭窄组(P<0.05)。采用ROC曲线分析结果显示,对于冠心病患者冠状动脉中、重度狭窄病变,MW参数均有预测价值,以GWE的诊断效能最大,其截断值为94.92%,ROC曲线下面积为0.912(95%CI 0.836~0.988),敏感度为90.2%,特异度为92.7%。结论MW参数对冠状动脉狭窄程度评估具有临床价值。Objective To explore the correlation between the severity of coronary artery stenosis and the myocardial work assessed by echocardiography.Method A total of 81 patients with coronary artery stenosis and 41 patients with normal coronary angiography from June 2021 to June 2023 were enrolled in this study in Beijing Aerospace General Hospital.According to the stenosis of coronary artery,patients were divided into severe stenosis group(n=41),moderate stenosis group(n=40)and normal group(n=41).All patients underwent coronary angiography,echocardiography and other examinations.The two-dimensional left ventricular global longitudinal strain(GLS)and myocardial work(MW)were analyzed.The receiver operating characteristic(ROC)curve was drawn to evaluate the diagnostic efficacy of MW for the stenosis of coronary artery.Result in the normal group GWI,GWE,GCW and LVEF were higher than that of severe coronary lesions and moderate group,moderate group is higher than the severe stenosis group(P<0.05).The normal group had a significantly lower GWW than the moderate and severe stenosis group,and the moderate stenosis group had a significantly lower GWW than the severe stenosis group(P<0.05).The Results of the ROC curve analysis show that for patients with coronary heart disease and moderate to severe stenosis lesions in the coronary arteries,the MW parameters all have predictive value.The diagnostic performance of GWE is the best,with a cutoff value of 94.92%,AUC of 0.912(95%CI 0.836-0.988),sensitivity of 90.2%,and specificity of 92.7%.Conclusion MW parameters of myocardial work quantitatively assessed by echocardiography are valuable in evaluating the degree of coronary artery stenosis.

关 键 词：心肌做功参数 超声心动图 冠状动脉粥样硬化性心脏病 冠状动脉狭窄 

分 类 号：R541.4[医药卫生—心血管疾病]