定量组织速度成像技术检测经皮腔内冠状动脉成形术后左心室局部收缩功能应用探讨

目的 采用超声定量组织速度成像(QTVI)技术观察冠心病患者经皮腔内冠状动脉成形术(PTCA)支架置入前后各节段心肌收缩期峰值速度(Vs),以定量分析左心室局部收缩功能.方法 16例健康人(对照组),20例因冠状动脉左前降支(LAD)狭窄接受PTCA支架置入治疗的冠心病患者,分别于治疗前1d、治疗后1周及1个月测量左前降支供血区各节段心肌收缩期峰值速度.结果:(1)与健康对照组比较,冠心病组治疗前1 d左前降支供血区各节段心肌Vs明显减低(P＜0.01)(心尖段除外);治疗后1个月室壁运动速度减低,除前间隔中段Vs达到正常值,其余节段仍低于健康对照组.(2)冠心病组治疗前后比较:上述速度减低节段治疗后1周较1 d Vs明显增快(P＜0.01);治疗后1个月较1周Vs继续增快(P＜0.01).结论 QTVI技术可用于定量分析PTCA支架置入治疗前后左心室局部心肌收缩功能的变化.

Quantitive analysis of regional left ventricular systolic function before and after PTCA by quantitative tissue velocity imaging

Objective To analyze regional left ventricular systolic function before and after percutaneous translumial coronary angioplasty(PTCA),quantitative tissue velocity imaging(QTVI)was used tO detect wall motion of left ventricule.Methods 20 patients with isolated left anterior descending coronary artery(LAD)stenosis(≥70%)and 16 normal control subjects were included in this study.QTVI was performed one day before PTCA+stent,a week and a month after successful PTCA+stent.Peak systolic myocardial velocity(Vs)were measured with QTVI at different wall segments(basal and medial segments).Results Before PTCA+stent,Vs of all segments assigned by LAD were significantly lower than those of corresponding segments in normal subjects(P＜0.01).After PTCA+stent,the above segments showed a significant improvement of Vs in a week and a month(P＜0.01).Conclusion QTVI can quantitively detect changes of myocardiac motion and real-time quantify regional left ventricular systolic function before and after PTCA.