斑点追踪成像评价冠心病患者左心室舒张期形变及解旋运动

目的 观察应用斑点追踪成像(STI)技术评价冠心病患者左心室舒张期形变及解旋运动的价值.方法 随机选择临床拟诊为冠心病患者117例,根据冠状动脉造影或冠状动脉CTA结果分成心肌梗死组(60例)、心肌缺血组(31例)及对照组(26例).常规测量二尖瓣口舒张期血流速度(E、A)及二尖瓣后瓣环的运动速度(E'、A'),计算E/E'.运用STI技术测量左心室舒张期各方向应变率、解旋率.结果 与心肌缺血组、对照组相比,心肌梗死组E/E'增大,纵向、径向、圆周方向舒张早期及晚期应变率、解旋率减低(P＜0.001)；与对照组比较,心肌缺血组仅解旋率、舒张早期纵向应变率、舒张早期与晚期圆周方向应变率减低,差异均有统计学意义(P均＜0.05).结论 STI技术能有效评价冠心病患者左心室舒张期各方向的形变及解旋运动；与常规超声参数相比较,左心室舒张期径向、圆周方向应变率及解旋率能更早地反映心肌缺血患者左心室舒张功能的减低.

Assessment of left ventricular diastolic deformation and untwist in patients with coronary artery disease using speckle tracking imaging

Objective To observe the value of left ventricular (LV) deformation and untwist in patients with coronary artery disease (CAD) using speckle tracking imaging (STI). Methods Totally 117 patients were randomly selected and divided into three groups according to the extent of coronary artery stenosis, i.e. myocardial infarction group (60 patients), myocardial ischemia group (31 patients) and control group (26 patients). All patients were examined with STI, and the parameters of LV, including early and late diastolic global longitudinal, radial and circumferential strain rate, as well as untwisting rate were calculated. E/E' (transmitral and mitral lateral annular early diastolic velocity ratio) was also measured and statistical analyzed. Results E/E' increased obviously in myocardial infarction group (P<0.05). Global longitudinal strain rate in early diastole, circumferential strain rate in early and late diastole and untwisting rate reduced markedly in myocardial infarction group (P<0.001). Global radial strain rate in early and late diastole, longitudinal strain rate in late diastole decreased in myocardial ischemia group compared with those of control group (all P<0.05). Conclusion LV diastolic deformation and untwist can be evaluated in patients of CAD with STI. Compared with routine parameters, circumferential, longitudinal strain rate in diastole and untwist rate can be better for reflecting diastolic function in patients of myocardial ischemia.