速度向量成像对冠心病患者左室扭转特征的评价

目的 探讨速度向量成像（VVI）技术在评价冠心病患者左室扭转方面的临床价值.方法 30例健康者为对照组,48例冠心病患者,根据冠状动脉造影的结果将冠心病患者分为缺血组20例和梗死组28例.采集受检者左室短轴（二尖瓣水平、心尖水平）二维图像,应用VVI软件测量左室扭转指标.结果 与对照组比较,缺血组扭转速度峰值（PtwV）减低（P〈0.05）,梗死组心尖旋转角度峰值（PAr）、左室扭转角度峰值（Ptw）、PtwV减低,任意两个节段达峰时间的差值（Tw-diff）增大,差异均有统计学意义（P〈0.05）;与缺血组比较,梗死组PtwV减低（P〈0.05）.Ptw与左室射血分数呈正相关（r=0.68,P〈0.05）.结论 VVI技术是研究冠心病患者心肌扭转特征的有效方法,左室扭转指标较常规超声心动图更能敏感地检出冠心病患者早期的心肌缺血改变.

Evaluation of left ventricular twist in patients with coronary heart disease by velocity vector imaging

Objective To explore the clinical value of velocity vector imaging （ VVI ） technology in evaluation of left ventricular twist in patients with coronary heart disease. Methods Forty - eight patients with CHD and 30 control subjects were enrolled in this study. Patients with CHD were divided into isehemia group （n --20 ） and MI group （n = 28 ） according to the results of coronary angiography. Two - dimensional images of the left ventricular short - axis views at basal and apical level were recorded. LV twist indexes were obtained by VVI software. Results Compared with control group, peak twist velocity （PtwV） was significantly decreased in ischemia group （ P 〈 0.05 ）, Peak apical rotation （ PAr）, peak twist （ Ptw ） and PtwV were significantly decreased in MI group, while time to peak twist difference （ Tw -diff） was significantly increased （ P 〈 0.05 ）. Compared with ischemia group, peak twist velocity （PtwV） was significantly decreased in MI group （ P 〈 0.05 ）, and there was positive correlation between Ptw and LVEF （ r = 0.68, P 〈 0.05 ）. Conclusion VVI is an effective method for exploring LV twist in patients with CHD, and LV twist indexes are more sensitive than conventional echoeardiography in detection of myocardial ischemia earlier in patients with CHD.