彩色室壁运动定量分析节段舒张功能异常在冠心病早期诊断中的应用

目的探讨应用彩色室壁运动(CK)和定量分析软件(ICKTM)检测左室节段舒张功能异常在冠心病早期诊断中的价值.方法运用彩色室壁运动(CK)检测24例主诉心前区疼痛患者和20例正常对照的左室节段舒张功能,通过定量分析软件(ICK TM)得到各节段的舒张指数(DI).24例患者同期行冠状动脉造影检查,CK检测异常者进行核素检查.结果20名正常人左室各节段舒张运动呈现同步性,DI分别为:左前降支供血节段(72士12)%,左旋支供血节段(76±11)%,右冠状动脉供血节段(71士12)%(P＞0.05).24例患者中12例经冠状动脉造影检查发现血管狭窄,狭窄相关节段舒张早期运动减低,DI较正常节段明显减低(P＜0.05).当以DI＜55%为异常标准时,CK检测心肌节段功能异常与冠状动脉造影和核素检查具有较高的符合率.结论应用CK和ICK TM定量分析软件能敏感地检测出左室节段舒张功能异常,为判断心肌缺血、早期诊断冠心病提供依据.

Quantitative analysis of regional diastolic dysfunction by color kinesis: application in early diagnosis of coronary artery disease

Objective To investigate the application of color kinesis (CK) and "ICK^TM Quantitative Analysis System", a method of analyzing regional left ventricular diastolic dysfunction, in early diagnosis of coronary artery disease(CAD). Methods Twenty-four patients with recent chest pain and twenty normal controls were subject to CK and ICK^TM to obtain regional diastolic index (DI). The twenty-four patients were also studied by coronary angiography and the patients with abnormal CK were further examined by single photon emission tomograhpy (SPECT). Results Diastolic synchronism of left ventricular sections was seen in twenty normal controls. Regional DI of the section supplied by anterior descending branch, circumflex branch and right coronary artery were (72±12)%, (76±11)% and (71±12)%,respectively (P>0.05). Of the patients, coronary artery stenosis were detected in twelve patients by angiography. Related regions showed decreased early diastolic movement and significant lower DI (P<0.05), as compared with that of non-stenosed regions. A comparatively higher diagnostic accuracy of CK in detecting regional myocardial function was acquired when we set DI<55% as a cut-off and angiography and SPECT as golden standards. Conclusion CK and "ICK^TM Quantitative Analysis System" was a sensitive method to detect regional left ventricular diastolic dysfunction and to provide information for early diagnosis of myocardial ischemia and CAD.