二维斑点追踪显像技术评价冠心病患者的左心房功能

目的探讨二维斑点追踪显像技术（2D-STI）评价冠心病（CAD）患者左心房功能的可行性。方法应用2D-STI技术测定左心房壁应变率曲线，分别测量左心室收缩期左心房应变率（SRs）、左心室舒张早期左心房峰值应变率（SRe）、左心室舒张晚期左心房应变率（SRa），并计算其平均值（mSRs、mSRe、mSRa）。应用改良的Simpson＇S法测量左心房最大容积（LAVmax）、左心房最小容积（LAVmin）、左心房P容积（LAVp），并计算左心房主动射血分数（LAAEF）和左心房被动射血分数（LAPEF）。结果①与对照组比较，CAD组LAVmax、LAVmin、LAVp均显著增大（P〈0．05或P〈0．01），LAAEF显著增大（P〈0．01），LAPEF显著降低（P〈0．05）；②与对照组比较，CAD组mSRs和mSRe均显著降低（P〈0．05或P〈0．01），mSRa显著增大（P〈0．01）。结论2D-STI技术可以定量评价CAD患者的左心房功能，表现为左心房储备功能和管道功能的减低，辅助泵功能的增强。

Assessment of left atrial function in the patients with coronary artery disease by two-dimensional speckle tracking imaging

Objective To assess left atrial function by two - dimensional specking - tracking imaging （2D - STI） in the patients with coronary artery disease （CAD）. Methods 2D - STI was performed on 30 hospitalized patients with CAD （CAD group） and 30 healthy subjects（ control group）. The peak strain rate of systolic, early and late diastolic （SRs, SRe, SRa） of left atrial wall were measured and the average strain rate （mSRs, mSRe, mSRa） were calculated. The maximal, minimum left atrial volume（ LAVmax and LAVmin） were measured, and left atrial passive ejection fraction （LAPEF） and left atrial active ejection fraction （LAAEF） were calculated with modified Simpson＇s method. Results ① LAVmax, LAVmin, LAVp and LAAEF were significantly increased, LAPEF was significantly decreased in CAD group （P 〈 0.05 ）. ②Compared with those of the control group, mSRs and mSRe of CAD group significantly decreased （ P 〈 0. 05 or P 〈 0. 01 ）, meanwhile mSRa significantly increased （ P 〈 0. 01 ）. Conclusions 2D - STI can be used to quan- titatively assess left atrial function in patients with CAD, presenting as decrease of reservoir function and conduit func- tion, enhancement of pump function.