二维应变成像评价冠心病患者左心室局部功能的价值

目的 探讨二维应变成像评价冠心病患者左前降支(LAD)不同程度狭窄时局部心功能改变的价值.方法 72例冠心病患者中非心肌梗死患者55例,根据LAD狭窄程度分组:A组(狭窄<50%)24例,B组(狭窄50%～75%)19例,C组(狭窄>75%)12例;17例心肌梗死患者为D组.应用二维应变成像检测LAD参与供血的11个节段应变和应变率参数的变化.结果 A组各节段峰值应变(S)、收缩期峰值应变率(SRS)与舒张早期峰值应变牢(SRE)较高尖.B组与A组比较有所下降,但差别无统计学意义(P>0.05).C组与A组、B组比较,部分节段测值下降,差别有统计学意义(P<0.05或P<0.01).D组各相关节段S、SRS与SRE均显著降低.A、B、C组舒张晚期峰值应变率(SRA)比较差别均无统计学意义,D组SRA显著下降.A组SRE>/SRA>1,B、C、D组SRE/SRA<1.结论 二维应变成像可以敏感反映血流灌注减少引起的局部心肌收缩、舒张功能下降,有利于早期发现心肌缺血.

Quantitative assessment of left ventricular myocardial function by two dimensional strain echocardiography

Objective To probe into the value of the evaluation of left ventricular myocardial function by two dimensional strain(2DS) for coronary artery disease(CAD) patients with different degrees of left anterior descending(LAD) branch stenosis. Methods Fifty-five eases without myocardial infarction among a total of 72 patients with CAD were divided in to 3 groups based on the extent of LAD stenosis,that was group A(stenosis<50%, n = 24) ,group B(stenosis50% to 75%, n = 19) ,and group C(stenosis>75%, n = 12). Another 17 eases of CAD with myocardial infarction were selected as group D. Strain and strain rate of the whole 11 segments that blood supplied by LAD of all cases were measured with 2DS. Results The 2DS ultrasound showed that the peak strain(S), the peak systolic strain rate(SRs) and the peak early diastolic strain rate (SRE) in all the 11 segments of group A were high and sharp. The above mentioned parameters of group B decreased compared with that of group A, however, there was no statistical significant difference (P >0.05). The S, SRs and SRE of group C cases decreased in some segments compared with that of group A and group B (P< 0.05 or P<0.01). As for group D, the S, SRS and SRE decreased significantly in all segments. In terms of the peak late diastolic strain rate (SRA), there were no statistical significant differences among group A,B and C (P>0.05). While in group D cases, the SRA decreased markedly. The SRE/SRA was more than 1 in group A. However, in group B, C and D cases, the SRE/SRA were all less than 1. Conclusions 2DS can sensitively reflect the decrease of regional myocardial systolic and diastolic function caused by the reduction of perfusion,and it may be beneficial to find myocardial ischemia for patients as early as possible.