速度向量成像评价冠心病介入治疗前后左心室整体收缩功能

目的 探讨速度向量成像(VVI)技术评价冠心病患者整体功能及介入治疗后的变化。方法 选择18例正常成人和22例冠心病患者作为研究对象。在VVI成像模式下采集标准经胸心尖四腔观、二腔观和胸骨旁二尖瓣尖、心尖水平的左室短轴二维动态图像。所有冠心病患者分别于经皮冠状动脉介入治疗(PCI)前1d及治疗后1周、1个月、3个月时采集图像，应用VVI软件测量左室旋转运动的心底、心尖旋转角度、旋转速率，计算左室扭转角度和扭距等整体运动信息。结果 心肌梗死组左室射血分数(LVEF)和左室扭矩(Ptor)均低于正常人和非心肌梗死组。PCI术后心肌梗死组和非心肌梗死组的LVEF均逐渐改善，心尖旋转角度、心尖旋转速率、左室扭转角度和Ptor变化趋势却相反：前者为术后1周或1个月内增高，术后3个月降低的趋势；后者为术后1周降低，术后1个月、3个月又逐渐增高的趋势。结论 VVI技术能定量评价左室扭转运动。与LVEF相比，左室扭转和扭矩更能体现两组冠心病患者在冠脉再通后左室整体收缩功能恢复过程中的不同特点。

Evaluation of left ventricular global systolic function using velocity vector imaging in patients with coronary heart disease before and after percutaneous coronary intervention therapy

Objective To analyze left ventricular (LV) global systolic function in patients with coronary artery disease(CAD) and their changes after percutaneous coronary intervention(PCI) using velocity vector imaging(VVI). Methods Eighteen healthy adults and twenty two patients with CAD were enrolled in this study. Two-dimensional dynamic images of standard apical four-chambers, two-chambers and parasternal short-axis views at the level of mitral valve and apex were obtained in VVI condition. All patients were examined 1 day before PCI, 1 week, 1 month and 3 months after PCI respectively. LV rotation degree, rotation velocity at baseline and apex were measured using the off-line syngo US workplace software and LV twist, torsion were calculated as global motion condition. Results LV ejection fraction(LVEF) and peak torsion at myocardial infarction group were lower than those at normal control and myocardial ischemia group. After PCI, LVEF were gradually improved in both myocardial infarction group and myocardial ischemia group,while changes of LV apex rotation degree and velocity, peak twist and peak torsion between two groups were opposite: those parameters of the former increased 1 week or 1 month after PCI but decreased 3 months after PCI,while those of the latter decreased 1 week after PCI but increased gradually 1 month and 3 months after PCI. Conclusions LV twist and torsion can be evaluated exactly by VVI.Compared with LVEF, LV twist and torsion can preferably reflect the different characteristic of LV global systolic function after coronary artery recanalization in myocardial infarction group and myocardial ischemia group.