二维斑点追踪评估急性心肌梗死患者经皮冠状动脉介入术后左室收缩功能

目的探讨二维斑点追踪(2D-STE)在评估急性心肌梗死(AMI)患者经皮冠状动脉介入(PCI)术后左室收缩功能和预后中的价值。方法选取接受急诊PCI治疗的AMI患者84例,于PCI术后3 d、1个月、3个月、6个月行2D-STE检查,比较手术前后常规超声心动图检查参数,以及心肌纵向应变(LS)、径向应变(RS)及圆周应变(CS)的差异;分析各应变差值(ΔLS、ΔRS、ΔCS)与左室射血分数(LVEF)的相关性。根据是否发生预后不良事件将84例患者分为预后良好组51例和预后不良组33例,比较两组临床及超声检查资料,应用多因素Logistic回归分析影响预后的不良因素。绘制受试者工作特征(ROC)曲线分析LS、RS、CS对AMI不良预后的诊断效能。结果 AMI患者PCI术后1个月、3个月、6个月左室舒张末期内径(LVDd)、左室收缩末期内径(LVDs)、左室舒张末期容积(LVEDV)、左室收缩末期容积(LVESV)均低于术后3 d(均P0.05),且术后3个月、6个月LVEDV和LVESV均低于术后1个月(均P0.05)。LVEF在PCI术后各时间点逐渐升高(P0.05);AMI患者LS、RS、CS在PCI术后各时间点均逐渐升高(均P0.05)。AMI患者术后3 d、1个月、3个月、6个月各应变参数差值ΔLS、ΔRS、ΔCS与LVEF均呈正相关(均P0.05)。预后良好组与预后不良组冠状动脉病变范围、LVEDV、LVESV、LVEF、LS、RS、CS比较,差异均有统计学意义(均P0.05)。多因素Logistic回归分析显示,冠状动脉病变范围、LVEF、LS、RS、CS均是AMI患者不良预后的独立影响因素(均P0.05);LS、RS、CS评估AMI患者不良预后的曲线下面积分别为0.746(95%CI:0.642～0.851)、0.691(95%CI:0.578～0.804)、0.729(95%CI:0.621～0.839)。结论 2D-STE可客观反映AMI患者PCI术后左室收缩功能的变化,能为AMI患者预后评估提供重要依据。     

超声斑点追踪成像评估舒张性心力衰竭兔的左室二维应变和扭转

目的 应用超声斑点追踪显像(STE)评价舒张性心力衰竭兔模型的左室二维应变及扭转运动的特点.方法 22只雄性新西兰兔随机分为两组:其中一组(12只)以肾上腹主动脉缩窄的方法建立舒张性心力衰竭模型;另一组为对照组(10只).应用STE技术测量左室纵向(LS)、径向(RS)、圆周应变(CS)及左室扭转相关参数,并行左室导管及心肌病理学检查.结果 DHF组左室LS、RS减低,tPtw延迟,IUR减低.CS、Ptw无差异.IUR与tau呈负相关,Ptw与EF,dp/dtmax呈正相关.结论 STE可有效评价DHF兔左室的二维应变和扭转运动.     

左心室整体纵向应变预测急性心肌梗死患者经皮冠状动脉介入术后左心室重构

目的 探讨应用二维斑点追踪(STE)技术预测急性心肌梗死(AMI)患者经皮冠状动脉介入(PCI)术后左心室重构(LVR)的价值。方法 对75例AMI患者于PCI术后72 h及6个月行STE检查,测算左心室整体圆周应变(GCS)及整体纵向应变(GLS)。以术后6个月左心室舒张末期容积(LVEDV)≥15%作为LVR诊断标准。进行统计学分析。结果 PCI术后6个月,75例中56例未发生重构(非重构组),19例发生LVR(重构组),发生率25.33%(19/75)。与术后72 h比较,重构组术后6个月LVEF减低,非重构组术后6个月LVEF增高(P均<0.05)。与非重构组比较,重构组术后72 h及术后6个月GCS及GLS均减低(P均<0.05)。LVEF、GCS及GLS均与LVR呈负相关(r=-0.39、-0.52、-0.64,P均<0.01)。GLS及GCS是LVR的独立预测因子。GLS的ROC曲线下面积最大,预测LVR的阈值为-12.45%,敏感度和特异度分别为86.3%及87.2%。STE参数测量观察者间差异为(9.32±3.14)%,观察者内差异为(7.18±2.26)%。结论 通过STE测得的GLS可用以准确预测AMI患者PCI术后LVR。     

超声心动图结合二维应变评价左室再同步化治疗慢性心力衰竭患者的短期疗效

目的:应用二维应变超声心动图评价慢性心力衰竭(chronic heart failure,CHF)患者在安装三腔起搏器进行左室再同步化治疗(cardiac resynchronization therapy,CRT)后的短期疗效。方法:选择行植入CRT的患者31例,分别在CRT术前、术后2周及术后3个月测量左室射血分数(left ventricular ejection fraction,LVEF)、左室舒张末内径(left ventricular end-dia-stolic diameter,LVEDD)、左室收缩末内径(left ventricular end-systolic diameter,LVESD),应用二维应变成像技术分析左室壁16个节段的径向应变(radial strain,RS)峰值、环向应变(circumferential strain,CS)峰值及纵向收缩期(longitudinal systolic strain,LS)峰值。结果:与术前相比,术后2周及术后3个月的LVEDD、LVESD和LVEF及左室壁16个节段的RS峰值、CS峰值和LS峰值均有不同程度改善。术后2周与术后3个月相比,LVEDD、LVESD、LVEF及左室壁16个节段的LS峰值差异均有统计学意义,而RS峰值与CS峰值差异均无统计学意义。术后2周及术后3个月心脏同步性均较术前有显著改善。结论:二维超声技术能定量检测CRT后心脏结构变化的数据。CRT术后可逆转心室重构,改善CHF患者的心功能。     

速度向量成像应变指标评价冠心病患者左心室局部和整体收缩功能

目的 应用速度向量成像(VVI)技术应变指标定量分析静息状态下冠心病患者左心室局部及整体收缩功能.方法 冠心病患者和健康志愿者各30例.采集心尖四腔、两腔及左室长轴观和二尖瓣环、乳头肌及心尖水平左室短轴观二维灰阶图像.按18节段法划分左室壁,分析各节段纵向(L)、周向(C)和径向(R)收缩期峰值应变(S).将LS、CS心内、外膜测值之差分别定为纵向应变跨壁阶差(LSG)、周向应变跨壁阶差(CSG);将左室壁所有节段各向应变平均值定为左室壁各向整体收缩期峰值应变并分别与左室射血分数(LVEF)作相关性分析.结果 A组为冠脉狭窄≤70%供血心肌,共176个节段,其LS及LSG明显低于对照组(P＜0.05),CS、RS及CSG与对照组差异无统计学意义(P＞0.05);B组为冠脉狭窄＞70%供血心肌,共132个节段,其LS、CS及RS均显著低于对照组(P＜0.05),LSG及CSG与对照组差异无统计学意义(P＞0.05).B组LS、RS、CS显著低于A组,LSG显著高于A组(P＜0.05),CSG与A组差异无统计学意义(P＞0.05).冠心病组各向整体收缩期峰值应变指标均与LVEF指标显著相关(P＜0.0001),其中GLS与LVEF指标相关系数最高.结论 VVI技术应变指标可以准确评价冠心病患者左心室收缩功能异常.局部心肌LS、RS、CS、LSG及CSG的变化可以反映冠脉狭窄的严重程度;左室壁GLS可以作为评价冠心病患者左心室整体收缩功能的新指标.     

斑点追踪成像评价急性心肌梗死后左室形变与重构的关系

目的应用斑点追踪成像评价急性心肌梗死冠脉介入治疗后患者局部、整体左室心肌形变及其与左室重构的关系。方法①对10例健康人和10例心肌梗死患者进行组织多普勒和斑点追踪成像结果的对比性分析。②回顾分析80例正常对照和30例急性心肌梗死PCI术后的患者,测量心尖两腔、三腔和四腔切面左室节段、整体峰值收缩长轴应变和应变率,并分析其与左室收缩末期容积(LVESV)、舒张末期容积(LVEDV)、室壁运动积分指数(WMSI)和左室射血分数(LVEF)的相关性。结果①应用STI、TDI两种方法测量正常心肌和缺血心肌左室峰值收缩长轴应变和应变率的结果均无统计学差异(P>0.05)。②正常组左室各节段峰值收缩长轴应变和应变率呈现一致性分布(P>0.05)。③心梗组左室各心肌节段峰值收缩长轴应变和应变率呈现不同程度的降低。④心梗组患者左室收缩、舒张末期长径和左室射血分数无差异(P>0.05),但LVESV、LVEDV和WMSI明显增加(P<0.05)。⑤峰值收缩二维总应变、总应变率与LVESV、LVEDV、LVEF和WMSI相关良好。结论斑点追踪成像既能定量测定左室局部和整体心肌的收缩形变,评价局部和整体心肌组织的收缩功能,且与反映左室重构的指标间相关良好。     

超声二维斑点追踪显像评价犬心肌梗死面积和心肌存活性的研究

目的 采用二维斑点追踪显像(STE)检测犬心肌梗死面积,识别存活心肌,并与病理对照.方法 13只犬左冠状动脉前降支(LAD)阻断180 min后再灌注120 min.在基础状态和再灌注后行STE 检查,检测左室乳头肌水平心肌径向、圆周和纵向方向的峰值应变(Speak)、峰值应变延迟时间(TPS)和收缩后应变指数(PSI).采用TTE染色检测节段心肌梗死面积占该节段面积的百分比(NA/RLV),NA/RLV≤50%为存活心肌.结果 再灌注后Speak减低,TPS延长,PSI增大.Speak与NA/RLV呈负相关,TPS和PSI则呈正相关.降低的径向和纵向Speak及延长的径向和纵向TPS是NA/RLV＞50%的独立预测因子.纵向Speak≥13.5%预测存活心肌的敏感性为76%,特异性为81%.结论 STE可准确评价节段心肌收缩功能,反映梗死心肌面积,识别存活心肌.     

NT-proBNP和MMP-9与急性心肌梗死患者早期左室重构的相关性研究

【目的】探讨氨基末端B型脑钠肽前体（N T‐proBN P ）、基质金属蛋白酶‐9（M M P‐9）对急性心肌梗死（AMI）患者经皮冠脉介入治疗（PCI）术后早期心室重构的影响及其相关性。【方法】根据PCI术后4周时92例AMI患者左心室容积增加率的不同,将其分为左室重构组,非左室重构组,并设稳定性冠心病对照组。比较患者NT‐proBNP、MMP‐9水平及其与PCI术后患者的左室收缩末期容积（ LVESV）和舒张末期容积（LVEDV）、左室射血分数（LVEF）、左室收缩末容积指数（ LVESVI）、左室舒张末容积指数（LVEDVI）等的关系。【结果】AMI患者PCI治疗前后血浆NT‐proBNP和MMP‐9水平较稳定型冠心病对照组明显升高;左室重构组血浆 NT‐proB‐NP、MMP‐9水平持续增高,与非左室重构组在PCI术后7 d比较差异有统计学意义（ P＜0．01）。血浆NT‐proB‐NP、MMP‐9水平与LVEDV均呈明显正相关（ P ＜0．01）,与LVEF均呈明显负相关（ P ＜0．05）。【结论】AMI患者血浆NT‐proBNP、MMP‐9水平与左室重构指标有相关性,可作为AMI早期左室重构的预测因子。     

二维斑点追踪显像评价肥厚型心肌病的左室心肌功能

目的:应用二维斑点追踪显像技术(STI)评价肥厚型心肌病(HCM)左室心肌功能的改变.方法:超声心动图检查30例HCM患者(HCM组)和30例健康对照者(对照组),获取二维灰阶动态图像.采用STI技术分析受检者纵向(LS)、径向(RS)、环向(CS)应变及左心室短轴水平的旋转角度峰值.结果:HCM组心肌整体LS、RS、CS收缩期峰值应变均低于对照组,心尖部旋转角度峰值低于对照组(P＜0.05).结论:HCM患者左室心肌应变和扭转能力降低.STI技术可有效评估HCM患者的左室心肌功能改变.     

经胸冠状动脉血流显像技术对急性心肌梗死经皮冠状动脉介入术后左室重构的预测价值

目的 探讨经胸冠状动脉血流显像技术对急性心肌梗死经皮冠状动脉介入（PCI）术后早期预测左室重构的价值.方法 急性心肌梗死患者行PCI术后成功再通前降支（LAD）患者39例,术后24～48 h采用经胸冠状动脉血流显像技术获取前降支血流频谱,测量舒张期减度时间（DDT）、左心室收缩末期容积（LVESV）、左室舒张末期容积（LVEDV）和射血分数（EF）,并计算室壁运动记分指数（WMSI）.根据术后6个月LVEDV增加百分比分为重构组（≥20%）和非重构组（＜20%）.分析各参数与术后6个月LVEDV增加百分比的相关性.结果 DDT与LVEDV增加百分比呈负相关（r=-0.524,P＜0.05）.以DDT≤327 ms为截断值,预测左室重构的敏感性为76.9%,特异性为76.0%.结论 经胸冠状动脉血流显像技术对急性心肌梗死成功行PCI术后早期左室重构具有一定预测价值     

Prediction for Improvement and Remodeling in First-Onset Myocardial Infarction by Speckle Tracking Echocardiography: Is Global or Regional Selection Better?

Cardiac function improvement and chamber remodeling after the onset of acute myocardial infarction (AMI) is crucial as it is closely related to the outcomes of patients. We sought to investigate the predictive value of left ventricular (LV) global and region of interest (ROI) assessment for prognosis of AMI patients by speckle tracking echocardiography (STE). We prospectively enrolled 81 first-onset AMI patients for baseline and 6-mo follow-up analysis. The echocardiography-derived parameters were compared in receiver operator characteristics (ROC) analysis for prediction of LV remodeling (LVR) (a minimum 20% increase of LV end-diastolic volume) and cardiac function improvement (a minimum 5% increase of LV ejection fraction). The ROI strain was selected by wall motion score index (WMSI) scores ≥2. The time of whole analysis process was recorded. Cut-off values of ?9.92% for global circumferential strain (CS) and ?5.53% for ROI CS predicted LVR. Cut-off values of ?10.40% for global longitudinal strain (LS) and ?5.33% for ROI LS predicted cardiac function improvement. Areas under curves of global and ROI parameters were comparable in ROC analysis (p > 0.05, all). The time of global analysis was less than the time of ROI analysis (p < 0.05) and the reproducibility of global analysis was slightly better than the ROI analysis. Our results demonstrated that STE was valuable for the prediction of LVR and cardiac function improvement after AMI. Compared with ROI parameters, global parameters were more integral and efficient as predictive factors with high predictive power, less analysis time and better reproducibility.     

Value of three-dimensional strain parameters for predicting left ventricular remodeling after ST-elevation myocardial infarction

This study was to evaluate the value of multi-directional strain parameters derived from three-dimensional (3D) speckle tracking echocardiography (STE) for predicting left ventricular (LV) remodeling after ST-elevation myocardial infarction (STEMI) treated with primary percutaneous coronary intervention (PCI) compared with that of two-dimensional (2D) global longitudinal strain (GLS). A total of 110 patients (mean age, 54?±?9 years) after STEMI treated with primary PCI were enrolled in our study. At baseline (within 24 h after PCI), standard 2D echocardiography, 2D STE and 3D STE were performed to acquire the conventional echocardiographic parameters and strain parameters. At 3-month follow-up, standard 2D echocardiography was repeated to all the patients to determine LV remodeling, which was defined as a 20% increase in LV end-diastolic volume. At 3-month follow-up, LV remodeling occurred in 26 patients (24%). Compared with patients without LV remodeling, patients with remodeling had significantly reduced 2D GLS (?12.5?±?3.2% vs ?15.0?±?3.1%, p?<?0.001), 3D GLS (?9.9?±?2.2% vs ?13.1?±?2.7%, p?<?0.001), 3D global area strain (GAS) (?20.3?±?3.9% vs ?23.3?±?4.8%, p?=?0.005) and 3D global radial strain (GRS) (29.0?±?7.4% vs 34.3?±?8.5%, p?=?0.007) at baseline, but there is no significant difference in 3D global circumferential strain (GCS) (?12.7?±?2.9% vs ?13.0?±?3.2%, p?=?0.822). Separated multivariate analysis shows that 2D GLS, 3D GLS, 3D GAS and 3D GRS all can be independent predictors of LV remodeling. However, receiver-operating characteristic curve analysis showed that the area under the curve of 3D GLS (0.82) for predicting LV remodeling was significantly higher than that of 2D GLS (0.72, p?=?0.034), 3D GAS (0.68, p?<?0.001) and 3D GRS (0.68, p?<?0.001). In patients after STEMI, 2D GLS, 3D GLS, 3D GAS and 3D GRS but not 3D GCS measured after primary PCI are independent predictors of LV remodeling and 3D GLS is the most powerful predictor among them.     

二维斑点追踪技术评价急性心肌梗死患者经皮冠状动脉介入治疗后冠状动脉侧支循环对左心室功能的影响

目的 采用二维斑点追踪成像(STE)技术评价急性心肌梗死(AMI)患者经皮冠状动脉介入治疗(PCI)后冠状动脉侧支循环(CCC)对左心室功能的影响。方法 选择接受急诊PCI的AMI患者51例,根据冠状动脉造影结果将患者分为有侧支循环组(CCC组)和无侧支循环组(N-CCC组)。再根据冠状动脉闭塞情况及室壁运动评分将患者左心室18节段心肌分为正常心肌组、缺血心肌组和梗死心肌组。患者分别在PCI术后72 h及1个月接受超声检查,检测并比较左心室心肌整体收缩、舒张功能及心肌纵向应变(LS)和应变率(LSR)。结果 与术后72 h比较,1个月时CCC组和N-CCC组缺血及梗死心肌的LS均增大(P<0.01)。术后72 h,CCC组缺血心肌LSR-s大于N-CCC组(P<0.05)。术后1个月,CCC组缺血及梗死心肌LS均大于N-CCC组(P<0.05),且恶性心律失常发生率低于N-CCC组(P<0.05)。结论 CCC可显著改善AMI患者PCI术后72 h缺血心肌和术后1个月缺血、梗死心肌的收缩功能及左心室整体舒张功能。     

二维斑点追踪成像评价急性心肌梗死后左心室收缩同步性

目的 采用超声二维斑点追踪成像(STE)评价急性心肌梗死(AMI)后左心室收缩同步性及其影响因素.方法 65例QRS宽度正常的AMI患者在AMI发作72 h之内及60名正常人行STE检查,检测心肌峰值纵向应变(LSpeak)代表心肌收缩功能,并测量左心室短轴水平心肌节段收缩期达峰值径向应变的时间(TRS),将前间壁和后壁TRS的差值(TAS-POST)≥130 ms定义为左心室收缩不同步.以心肌室壁运动评分指数(WMSI)代表AMI面积(MIS).结果 AMI患者左心室射血分数(LVEF)和LSpeak减小,TAS-POST延长.AMI导致左心室收缩不同步的发生率为64.62%(42/65).TAS-POST 与LVEF、LSpeak和MIS(WMSI)显著相关,与QRS宽度无相关性.MIS(WMSI)是TAS-POST最有力的独立预测因素.结论 QRS宽度正常的AMI患者可出现左心室收缩不同步,且MIS是收缩不同步的主要影响因素.STE能够准确评价左心室收缩同步性.     

早期心脏康复程序对急性心肌梗死患者经皮冠状动脉介入术后心脏收缩功能的影响

目的:通过三维斑点追踪成像技术评估急性心肌梗死患者(AMI)经皮冠状动脉介入术(PCI)后的左室整体及局部收缩功能变化,探讨以社区为主的早期心脏康复训练对AMI患者的心功能影响。方法:根据是否愿意参加心脏康复,将急性心肌梗死术后患者分为康复组(25例)和对照组(25例)。其中,康复组参与12周的心脏康复程序,进行早期心脏康复训练。对照组仅接受常规护理。在研究开始前、结束后,所有患者均接受三维斑点追踪成像(Three-dimensional speckle tracking imaging,3D-STI)检查,获得左心室整体及各节段纵向、径向、周向及面积应变值(LS、RS、CS、AS)。结果:经过12周的康复程序后,康复组的整体纵向应变(global longitudinal strain,GLS)、整体圆周应变(global circumferential strain,GCS)、整体径向应变(global radial strain,GRS)、整体面积应变(global area strain,GAS)及左室射血分数(left ventricular ejection fraction,LVEF)较对照组显著增加(P0.01)。根据左室心肌节段分区法,两组间左前降支供血区域各有150节段,左回旋支供血区域各有125节段,右冠脉供血区域各有125节段。经过12周的康复程序后,康复组不同冠脉供血区域的LS、RS、CS、AS较对照组显著增加(P0.05)。结论:早期心脏康复治疗可以改善经PCI术后患者的心脏收缩功能。     

Assessment of myocardial viability in patients with acute myocardial infarction by two-dimensional speckle tracking echocardiography combined with low-dose dobutamine stress echocardiography

It is clinically important to determine the myocardial viability of regional wall motion abnormality segments in patients with acute myocardial infarction (AMI). The purpose of this study was to ascertain the ability and value of a combination of speckle tracking echocardiography (STE) and low dose dobutamine stress echocardiography (LDDSE) for the evaluation of viable myocardium in patients with AMI. Forty-two hospitalized patients with AMI and left ventricular systolic dysfunction (left ventricular ejection fraction <50 %) were underwent STE in conjunction with LDDSE and dual isotope simultaneous acquisition single photon emission computed tomography (DISA-SPECT). Percutaneous coronary intervention (PCI) was performed subsequently in all patients. STE was used to measure radial, circumferential, and longitudinal end-systolic strain and peak systolic strain rate. The movement of each segment was observed by routine echocardiography 1, 3, and 6 months after PCI, and its improvement over time was the criterion of viable myocardium. The sensitivity, specificity and accuracy of DISA-SPECT for the assessment of viable myocardium were 83.6, 74.4, and 80.7 %, respectively. Among the radial, circumferential, and longitudinal strain and strain rate parameters, only longitudinal strain (LS) and longitudinal strain rate (LSr) at rest and LDDSE emerged as independent predictors of viable myocardium, When combining LS and LSr at LDDSE, the sensitivity, specificity and accuracy for the assessment of viable myocardium rose to 89.8, 90.2 and 89.9 %, respectively. The sensitivity of STE in conjunction with LDDSE was similar to DISA-SPECT for detecting viable myocardium in patients with AMI, but the specificity and accuracy of STE performed with LDDSE were higher than DISA-SPECT.     

Non-contrast cardiac CT immediately after percutaneous coronary intervention: does it predict the risk of left ventricular remodeling in patients with ST-elevation myocardial infarction?

To assess the clinical utility of non-contrast cardiac CT (CCT) immediately after successful percutaneous coronary intervention (PCI) for predicting the risk of left ventricle (LV) remodeling in the management of patients with acute myocardial infarction (AMI), 35 patients with AMI underwent non-contrast CCT immediately after PCI. Volume and transmural extent of myocardial delayed enhancement (DE) were assessed on non-contrast CCT. Serial echocardiography and serologic biomarkers were evaluated at baseline and at 2 and 12 months after AMI. Based on an increase in left ventricular end-diastolic volume (LVEDV) ≥20?% at 2 months, patients were classified into two groups: LV remodeling (group 1, n?=?14) and no LV remodeling (group 2, n?=?21). Clinical characteristics, imaging parameters, and serologic biomarkers were compared between the two groups. Higher incidence of hypertension, longer time to reperfusion, and higher Killip classification at admission were observed for group 1 than for group 2, but these differences were not statistically significant (P?>?0.05). Greater volume and transmural extent of DE on non-contrast CCT and poorer resolution of ST-segment elevation on ECG were observed in group 1 compared to group 2, but these results were not statistically significant (P?>?0.05). Measurement of biochemical markers showed that probrain natriuretic peptide (proBNP), initial high sensitivity C reactive protein (hs-CRP), and maximum troponin T level were significantly higher in group 1 than in group 2 (P?<?0.05) at 2 months. Based on the trend of greater volume and transmural extent of DE in group 1 compared to group 2, non-contrast CCT immediately after PCI, in combination with serologic biomarkers (proBNP, hs-CRP, and troponin T) might be useful for managing patients with AMI.     

经皮血栓吸除术治疗急性心肌梗死无复流的疗效观察

目的应用实时心肌声学造影（RT-MCE）评价经皮血栓吸除术治疗急性心肌梗死（AMI）无复流的疗效。方法将68例证实梗死相关动脉有血栓形成的急性ST段抬高型心肌梗死（STEMI）患者随机分为单纯急诊经皮冠状动脉介入治疗（PCI）组和PCI联合血栓吸除术组,每组34例。于PCI后24h和1周行RT-MCE,记录两组灌注对比积分指数（CSI）、室壁运动积分指数（WMSI）、透壁性对比缺损长度百分比（CDL/LV）和严重室壁运动异常长度百分比（WML/LV）。结果术后24h和1周PCI联合血栓吸除术组CSI、WMSI、CDL/LV和WML/LV较单纯PCI组明显降低,且1周时较24h降低更明显（P〈0.05或P〈0.01）。结论经皮血栓吸除术可明显减少术后无复流的发生,改善微循环以及心脏功能,使PCI对AMI更有效。     

心室短轴斑点追踪成像评价心肌梗死

目的 采用超声心动图斑点追踪成像（STI）技术对心肌梗死心室短轴节段不同形式的运动进行评价。方法 分离结扎32只新西兰白兔冠状动脉前降支第一对角支造成前间隔及前壁心尖段心肌梗死，于梗死前正常状态及梗死后2周分别行超声心动图检查，应用STI技术分析左室短轴基底段及心尖段心室节段径向应变（RS）、圆周方向应变（CS）以及局部心肌旋转（Rot）。根据心肌梗死后左室射血分数（EF）下降的程度，将实验动物分为EF显著下降组及EF轻微下降组，分析RS、CS及Rot变化。结果心肌梗死后梗死段RS、CS以及Rot均下降；EF轻微下降组梗死段RS及Rot较正常时减低。结论STI能够评价左室短轴各个方向运动，心肌梗死后梗死段短轴各方向应变减低；整体EF无明显变化时，STI部分指标仍能敏感地检测出局部心肌收缩功能的变化。