超声二维应变评价冠状动脉介入治疗后左心室心肌收缩功能

目的应用超声二维应变（2DS）技术观察单支和多支冠状动脉病变心绞痛患者经皮冠状动脉介入治疗（PCI）后左心室局部心肌径向收缩功能改变有无差异。方法将63例心绞痛患者根据冠状动脉造影结果分为单支病变组（n=33）和多支病变组（n=30）,另选志愿者30名作为正常对照组,分别记录PCI术前、术后3个月及正常对照组左心室基底水平、乳头肌水平及心尖部水平18个室壁节段的二维灰阶图像。应用GE Echo PAC软件测量左心室短轴各室壁节段收缩期峰值径向应变。结果与正常对照组比较,单支病变组和多支病变组PCI术前大部分心肌节段和术后3个月部分心肌节段的左心室收缩期短轴峰值径向应变减低（P〈0.05）;单支病变组PCI术后3个月73.51%（136/185）心肌缺血节段恢复到正常水平,与多支病变组54.11%（158/292）差异有统计学意义（P〈0.01）。结论不同冠状动脉病变心绞痛患者PCI术后左心室径向收缩功能改善情况有所不同。

Two-dimensional strain in evaluating regional myocardial function after percutaneous coronary intervention

Objective To explore the characteristics of left ventricular myocardial function after percutaneous coronary intervention (PCI) in patients with angina pectoris of single-vessel and multiple-vessel coronary artery disease with two-dimensional strain (2DS). Methods Totally 63 patients with angina pectoris were divided to single-vessel coronary artery group (n=33) and multiple-vessel coronary artery group (n=30) based on coronary angiography, and 30 healthy volunteers were enrolled as control group. The two-dimensional images were obtained before and 3 months after PCI, and two-dimensional radial strain was analyzed on GE Echo PAC system. Peak radial strain values of left ventricular basal plane, papillary muscle plane and apical plane during systole were measured. Results Compared to control group, left ventricular peak systolic radial strain values decreased in many segments in patients with single-vessel coronary artery group and multiple-vessel coronary artery group before and 3 months after PCI (P<0.05). Totally 136 and 158 left ventricular ischemic segments attained to normal 3 months after PCI in single-vessel coronary artery group (136/185, 73.51%) and multiple-vessel coronary artery group (158/292, 54.11%), respectively (P<0.01). Conclusion The improvements of peak systolic radial strain are significantly different between angina pectoris patients with single-vessel and multiple-vessels coronary artery disease after PCI.