速度向量成像对不伴心肌梗死的冠心病患者左室收缩应变的研究

目的探讨速度向量成像技术（velocity vector imaging，VVI）对不伴心肌梗死的冠心病患者的诊断价值。方法对72例冠心病患者进行超声心动图检查，并追踪造影结果，应用VVI软件测量心肌纵向、径向、圆周左室峰值收缩期应变，根据冠脉造影结果分为3组，A组：冠造阴性及狭窄程度〈50％，B组：50％≤狭窄程度〈75％，C组：狭窄程度≥75％，比较组问差异。结果C组与A、B组之间纵向峰值收缩应变差异有统计学意义（P〈0．05），截断值-1828％，诊断狭窄程度≥75％的特异度为80％，敏感度为76％；C组与A、B组之间径向峰值收缩应变差异有统计学意义（P〈0．05），截断值25．88％，诊断狭窄程度≥75％的特异度为71％，敏感度为70％；而C组与A、B组之间圆周峰值收缩应变差异无统计学意义（P〉0．05）；A组与B组之间纵向、径向及圆周峰值收缩应变差异均无统计学意义（均P〉0．05）。结论VVI能帮助检测出不伴心肌梗死而有重度冠脉狭窄患者的左室心肌收缩功能异常。

Assessments of Left Ventricular Peak Systolic Strain with Velocity Vector Imaging in the Patients with Coronary Disease without Myocardial Infarction

Objective To evaluate the diagnostic values by using velocity vector imaging in patients with coronary disease without myocardial infarction. Methods On conventional two-dimensional echocardiography, 72 patients were examed and underwent coronary angiography within one week. The myocardial longitudinal, radial and circumferential strain were measured. The patients were classified into three groups according to the result of coronary angiography （A： 〈 50%, B：≥50% and 〈 75%, C： ≥75%）. Then the differences were analyzed among groups. Results The peak systolic longitudinal strain was reduced in myocardial segments subtended by coronary arteries with greater than 75% stenosis when compared with those subtended by coronary arteries with less than 75% stenosis and without stenosis （P 〈0.05）. Cutoff value -18.28%, specificity and sensitivity were 80% and 76%, respectively, for peak systolic longitudinal strain to diagnose segments subtended by coronary arteries with greater than 75% stenosis. The peak systolic radial strain was reduced in the same inter-groups （P 〈0.05）. Cutoff value 25.88%, specificity and sensitivity were 71% and 70%, respectively, for peak systolic radial strain to diagnose segments subtended by coronary arteries with greater than 75% stenosis. There were no significant differences in circumferential strain among the same groups （P 〉0.05）. There were no significant differences in longitudinal, radial and circumferential strain between the intermediate group and the control group （P 〉0.05）. Conclusion VVI can help to identify left ventricular myocardial systolic function abnormali- ties in patients with severe coronary stenosis but without myocardial infarction.