斑点追踪超声心动图评估冠状动脉杂交血运重建术短期疗效

目的应用二维斑点追踪超声心动图(2D-STE)定量评价冠心病多支病变患者行冠状动脉杂交血运重建术(HCR)术前、术后左室心肌功能变化,探讨HCR短期治疗效果。方法选取经冠状动脉造影诊断为多支病变且成功行HCR术的冠心病患者30例,另外选取20例健康志愿者作为对照组,测量常规及2D-STE超声心动图参数,左室整体长轴应变改善的影响因素采用线性回归分析。结果(1)与对照组相比,HCR组术前左室射血分数、左室长轴应变及圆周应变均减低(P<0.05)。(2)HCR术后8周,各常规超声心动图参数改变较术前无统计学意义(P>0.05),左室长轴应变及圆周应变较术前有所改善,但仍低于对照组,差异有统计学意义(P<0.05)。(3)多元线性回归分析显示SYNTAX评分、术前左室整体长轴应变是术后左室整体长轴应变改善的独立预测因子。结论冠心病冠状动脉多支病变患者左室心肌功能减低,HCR术后8周左室心肌功能明显改善,HCR短期疗效显著。

Evaluation of Short-term Efficiency of Hybrid Coronary Revascularization by Specking Tracking Echocardiography

Objective To evaluate left ventricular myocardial function of coronary artery disease(CAD)patients pre-and post-hybrid coronary revascularization(HCR)using 2 D specking tracking echocardiography(2 D-STE)and discuss the clinical value of HCR.Methods Thirty patients diagnosed with coronary multivessel disease by coronary angiography and received HCR were enrolled.Twenty volunteers were enrolled as the control group.Conventional and 2 D-STE Echocardiography parameters were measured.The independent predictor ofΔGLS was analyzed through linear regression analysis.Results(1)Compared to the control group,HCR group had a decreased LVEF,longitudinal and circumferential strain value(P<0.05).(2)8 weeks after HCR,the traditional echocardiography parameters showed no significant difference compare to those before HCR(P>0.05),longitudinal and circumferential strain value were increased compared to those before HCR,but still decreased compared to those of the control group(P<0.05).(3)The multivariate linear regression analysis showed that SYNTAX score and LVGLS were independent predictors ofΔGLS.Conclusions The left ventricular myocardial function in CAD patients with multi-vessel coronary artery diseases is decreased compared to healthy people and is improved significantly 8 weeks after HCR.