二维斑点追踪技术评价冠心病患者左室整体收缩功能及其与冠状动脉病变程度的关系

目的：应用二维斑点追踪技术(2DSTI)评价冠心病患者左室整体心肌收缩功能,探讨左室整体收缩功能与冠状动脉病变程度的关系。方法收集经冠状动脉造影证实的冠心病患者作为冠心病组(n=51),造影结果阴性者为对照组(n=30),其中冠心病患者根据Gensini积分分为轻度病变组(<25分)、中度病变组(25~49分)、重度病变组(≥50分),应用2DSTI技术测量左室整体纵向应变(GLS)、左室整体环向应变( GCS),比较各组间差异,分析其诊断价值,并用各测量值与Gensini积分进行相关性分析。结果与对照组比较,冠心病组GLS、GCS均低于对照组( P<0．05),随着冠状动脉病变程度的加重, GLS、GCS进行性减小( P<0．05)。受试者工作特征(ROC)曲线显示,GLS、GCS诊断冠心病的敏感性分别为94．1%、66．7%,特异性分别为66．7%、96．7%。相关分析表明冠心病组GLS、GCS与Gensini积分之间呈负相关(r=-0．70,P<0．01；r=-0．67,P<0．01)。结论冠心病患者心肌收缩功能均有不同程度受损,且随着冠状动脉病变程度的加重而加重,2DSTI可以定量评价左室整体收缩功能,具有临床诊断价值并能反映冠状动脉病变程度。

Assessment of left ventricular global systolic function in patients with coronary artery disease and its relationship with the degree of coronary artery disease by using two-dimentional speckle tracking imaging

Objective To evaluate left global ventricular systolic function in patients with coronary artery disease by using two-dimentional speckle tracking imaging(2DSTI),and to explore the relationship between left global ven-tricular systolic function and the degree of coronary artery disease. Methods The patients confirmed by coronary angiography were collected as a CHD group(n=51),negative angiographic results as a control group(n=30). Ac-cording to the Gensini score,the CHD group was divided into mild cases of group ( <25 points) , moderate cases of group (25~49 points) and severe cases of group ( ≥50 points) . Left ventricular global longitudinal strain( GLS) and left ventricular global circumferential strain ( GCS) were measured by 2DSTI. The differences between two groups were compared,and the diagnose value was analyzed. The parameters and Gensini score were used to carry on correlation analysis. Results Compared with control group, GLS,GCS decreased in CHD group(P<0. 05). With the severity of coronary artery disease,GLS and GCS decreased progressively (P<0. 05). The receiver operat-ing characteristic ( ROC) curve showed the sensitivity of GLS,GCS in the diagnosis of CHD was 94. 1%,66. 7%, while the specificity of them was 66. 7%,96. 7%. Correlation analysis showed that GLS,GCS were negatively cor-related with Gensini score (r= -0. 70,P<0. 01;r2 = -0. 67,P<0. 01). Conclusion Myocardial contractile function in patients with coronary artery disease is damaged to varying degrees,which aggravates the severity of cor-onary artery disease. 2DSTI can evaluate left global ventricular systolic function quantitatively,also has clinical di-agnostic value and can reflect the severity of coronary artery disease in addition.