解剖M型超声技术评价冠状动脉左回旋支支架置入术前后左心室侧壁运动变化

目的采用解剖M型（AMM）超声技术观察冠状动脉左回旋支内支架置入术或冠状动脉搭桥术后左室侧壁运动的改变。方法28例行冠状动脉左回旋支支架置入术或冠状动脉搭桥术的患者,在术前、术后72h及3个月时分别进行超声心动图检查,在二尖瓣水平短轴切面和乳头肌水平短轴切面获取前间隔、前壁、前侧壁、下侧壁、下壁和下间隔等各6个节段,在心尖四腔水平切面获取室间隔中间段、侧壁中间段、室间隔基底段和侧壁基底段等4个节段的解剖M型图像,测量这些节段的室壁收缩期增厚率。结果28例左回旋支狭窄置入支架的患者,相比术前,术后72h及3个月时,由左回旋支供血的心肌各节段的室壁收缩期增厚率均较术前显著增高,而术后72h内和术后3个月时的室壁收缩期增厚率则无显著差异。结论冠状动脉内支架置入术或冠状动脉搭桥手术能迅速改善狭窄动脉供血区域的室壁运动状况,并至少维持3个月;采用AMM超声技术测量室壁节段的收缩期增厚率,能随访评价支架置入术或冠状动脉搭桥术的疗效。

Detection of left ventricular lateral wall motion changes by anatomic M-mode echocardiography

Objective To evaluate left ventricular（LV）lateral wall motion changes before and after a successful coronary artery stent implantation or coronary bypass surgery （CABG） by anatomic M-mode echocardiography. Methods Twenty-eight patients with left circumflex coronary artery（LCX） disease were studied by transthoracic echocardiography at 72 h before, 72 h after and 3 months after the coronary stenting procedure or CABG. The wall thickening fraction （WTF） was measured at each of the 6 LV segments from the parasternal short-axis views and the apical 4 chamber view. Results In the 28 patients with I.CX disease, the WTF of LV anterolateral wall, inferolateral wall, middle lateral wall and basal lateral wall were all improved significantly both 72 h after and 3 months after LCX stenting or CABG, compared with that measured before the procedures. The mean values of WTF of these segments measured 72 h after LCX stenting or CABG were not significantly different from those measured 3 months after. Conclusion Regional LV systolic function relevant to LCX disease can he improved promptly after a successful coronary artery stenting or CABG. This improvement persists for at least 3 months. Measuring segmental WTF using anatomic M-mode echocardiography can evaluate and follow-up the treatment efficacy of coronary interventions.