应变率显像结合定量组织速度显像评价冠心病患者支架置入术前后左室功能

目的探讨应变率显像（SRI）技术结合定量组织速度显像（QTVI）技术在评价冠心病患者冠状动脉支架置入术前后左室功能的临床价值。方法28例冠状动脉中重度狭窄的冠心病患者，分别于支架置入术前、术后1周和1个月行超声心动图检查：QTVI测量二尖瓣环收缩期、舒张早期、舒张晚期峰值运动速度Sa、Ea和Aa，SRI测量各狭窄冠脉供血节段（缺血节段）收缩期、舒张早期、舒张晚期心肌长轴峰值应变率SRs、SRe和SRa；计算Ea／Aa和SRe／SRa；比较分析支架置入前后各检测指标。结果①与术前比较，术后1周Ea／Aa显著增高（P〈0．01）；与术前及术后1周比较，术后1个月sa、Ea和Ea／Aa均显著增高（P〈0．05或〈0．01）。②与术前比较，术后1周SRe、SRe／SRa显著增高（P〈0．01），与术前及术后1周比较，术后1个月SRs、SRe、SRe／SRa均显著增高（P〈0．05或〈0．01）。⑧术前、术后1周、术后1个月Ea／Aa与SRe／SRa均呈显著正相关（P〈0．01）。结论SRI结合QTVI可对支架置入术前后心脏局部和整体功能作出全面客观的评价，从而为术前手术指征的确定及术后疗效的判定提供一个新思路。

Strain rate imaging and quantitative tissue velocity imaging for evaluation of left ventricular function before and after stent implantation in patients with coronary artery disease

Objective To explore the clinical value of quantitative tissue velocity imaging （QTVI） and strain rate imaging（SRI） in evaluating left ventricular function before and after stent implantation in patients with coronary heart disease （CHD）. Methods Echocardiography were performed in 28 patients with CHD before one week and one month after stent implantation. The peak systolic velocities（Sa） , early diastolic velocities（ Ea） and late diastolic velocities（Aa） of mitral annular were measured by QTVI. The Peak systolic strain rate （ SRs ） , early diastolic strain rate （ SRe ） and late diastolic strain rate （SRa） of left ventricular isehemia segments were measured by SRI. Ea/Aa and SRe/Sra were calculated, and the results were compared and analyzed before and after stent implantation. Results ①Compared with before stent implantation, Ea/Aa of mitral annulus one week after stent implantation was increased significantly （ P 〈 0.01 ）. ②Compared with prestent implantation, SRe and SRe/SRa were increased significantly at one week after stent implantation （P 〈 0.01 ） , and compared with one week before and after stent implantation, SRs、 SRe and SRe/SRa were increased significant at one-month after stent implantation （P〈0.05 or 〈0.01 ）. ③There was positive correlation between Ea/Aa and SRe/SRa before one week and one month after stent implantation（ P 〈 0.01 ）. Conclusion SRI combined with QTVI can globally and objectively evaluate heart local and global function before and after stent implantation, and can provide a new method to assess surgical indication before stent implantation and curative effect after stent implantation.