三维超声斑点追踪成像技术对冠心病患者左心室整体应变的评价

目的:应用三维超声斑点追踪成像技术评价冠心病患者左心室整体应变指标变化。方法:入选我院行冠状动脉造影检查者71例,以冠状动脉狭窄是否50%分为病变组(n=47)与对照组(n=26)。冠状动脉狭窄组按是否存在心肌梗死分为心肌缺血组(n=25)及心肌梗死组(n=22)两个亚组。所有入选者应用Toshiba Artida彩色多普勒超声诊断仪,采集标准心尖四腔心切面左心室全容积图像并存储,应用3DT在线分析软件,对各组整体应变参数进行分析,包括:整体纵向峰值应变、整体径向峰值应变、整体周向峰值应变。结果:1心肌梗死组与心肌缺血组、对照组比较:左心房内径、左心室舒张末期内径、舒张末期容积增大(P0.05或P0.01)。左心室射血分数,二尖瓣血流频谱E/A明显减低(P0.05或P0.01)。心肌缺血组与对照组比较,上述各项指标差异无统计学意义(P0.05)。2心肌梗死组左心室整体纵向收缩期峰值应变,低于对照组及心肌缺血组(均P0.01),心肌缺血组低于对照组(P0.05)。3心肌梗死组左心室整体径向收缩期峰值应变,低于对照组及心肌缺血组(均P0.01),心肌缺血组低于对照组,但差异无统计学意义。4心肌梗死组左心室整体周向应变,参数较对照组和心肌缺血组明显减低(均P0.01)。心肌缺血组者左心室整体周向应变峰值较对照组减低P0.05)。结论:本研究显示三维斑点追踪技术可以通过多项应变参数评价冠心病患者左心室整体收缩功能。冠心病早期缺血时周向应变已经出现减低,发生心肌梗死后,心肌形变能力及运动协调性将进一步减低,左心室整体径向、周向、纵向应变均明显减低。

Three-dimensional speckle tracking imaging in evaluating left ventricle global strain in patients with coronary heart disease

Objective： Using three-dimensional ultrasound speckle tracking imaging to evaluate global strain of left ventricular in patients with coronary artery disease. Methods： 71 patients undergone coronary angiography were enrolled in the study. In cases of whether the coronary artery stenosis is greater than 50%,those people were divided into the lesion group（ n = 47） and normal group（ n = 26）. Coronary stenosis group was divided into two subgroups by whether there was the presence of myocardial infarction,myocardial ischemia group（ n =25） and myocardial infarction group（ n =22）. Toshiba Artida color Doppler was used to collect and store standard apical four chamber view of left ventricular full volume images. And 3DST online analysis software was used to analyze each group,including： the global longitudinal strain（ GLS）,global radial strain（ GRS） and global circumferential strain（ GCS）. Results： 1 The left atrial diameter,left ventricular end-diastolic diameter,end-diastolic volume increased in myocardial infarction and myocardial ischemia group,compared to the control group（ P〈0.05 or P〈0.01）,while the left ventricular ejection fraction,mitral E /A was significantly lower（ P〈0.05 or P〈0.01）. Those indicators showed no significant difference between myocardial ischemia and the control group（ P〈0.05）. 2 GLS of myocardial infarction group was less than the control group and the myocardial ischemia group（ P〈0.01）,while GLS of myocardial ischemia group was less than the normal group（ P〈0.05）. 3GRS of myocardial infarction group was less than the control group and the myocardial ischemia group（ P〈0.01）,while GRS of myocardial ischemia group was less than the normal group（ P〈0.05）. 4. GCS of myocardial infarction group was less than the control group and the myocardial ischemia group（ P〈0.01）,while GCS of myocardial ischemia group was less than the control group,but there was no significant difference between myocardial ischemia and the