摘要
目的探讨采用组织运动二尖瓣环位移自动追踪技术（TMAD）评价冠状动脉粥样硬化性心脏病（CAD）患者经皮冠状动脉介入术（PCI）后6个月左心室整体收缩功能改变的价值。方法选择2012年11月至2013年12月首都医科大学附属北京天坛医院心内科住院CAD患者22例,全部经冠状动脉造影证实前降支狭窄程度≥70%、成功行PCI术、并成功追踪6个月。其中男性16例,女性6例,年龄39~67岁,平均年龄（52.8±5.5）岁;健康对照组35例,其中男性25例,女性10例,年龄33~59岁,平均年龄（50.2±9.1）岁。在心尖四腔心和两腔心切面应用双平面Simpson′s法测量左心室射血分数（LVEF）。于标准的心尖四腔心、三腔心、两腔心切面,选择连续3~5个心动周期存储动态图像（CAD患者于术前及术后6个月存储图像）,用Qlab 7.0软件进行脱机分析。测量二尖瓣环6个位点收缩期最大位移（Ds）,瓣环连线中点最大位移（D-mid）,左心室长轴缩短率（FSL）,计算6个位点Ds均值,3个切面D-mid均值、FSL均值。比较对照组与CAD组术前、后上述指标是否存在差异,分析二尖瓣环位移指标与LVEF的相关性。结果与健康对照组比较,CAD组术前常规超声测量指标左心房前后径（LAd）、左心室舒张末内径（LVd）、左心室舒张末容积（LVEDV）、左心室收缩末容积（LVESV）增加[（3.43±0.17）cm vs（3.66±0.21）cm,（4.60±0.23）cm vs（4.89±0.43）cm,（82.51±6.22）ml vs（88.47±9.71）ml,（25.81±3.81）ml vs（38.90±7.24）ml];与健康对照组比较,左心室射血分数（LVEF）降低[（64.75±3.43）%vs（56.41±7.17）%],差异均有统计学意义（t=-3.24、-2.67、-2.60、-6.50、5.53,P均〈0.05）。PCI术后6个月,LAd、LVd、LVEDV、LVESV降低[（3.57±0.18）cm、（4.76±0.31）cm、（86.86±8.69）ml、（37.08±8.31）ml],LVEF升高（58.85±6.19）%,与术前比较差异均有统计学意义（t=2.33、2.79、2.48、3.18、-2.12,P均�
Objective To discuss the value of the left ventricular global systolic function in patients with coronary atherosclerotic disease before and after percutaneous coronary intervention（PCI） operation by tissue automated motion tracking of mitral annular displacement（TMAD）. Methods Twentytwo patients（16 males and 6 females, age 39-67 years old） with coronary atherosclerotic heart disease in the department of cardiology of our hospital who were successfully undergone PCI and successfully tracked for 6 months（coronary artery stenosis ≥ 70%, which were confirmed by coronary angiography）, and 35 normal controls（25 males and 10 females, age 33-59 years old） were enrolled in this study. After routine echocardiography, left ventricular ejection fraction（LVEF） was measured by biplane Simpson＇s method. Apical four-chamber, three-chamber and two-chamber two-dimensional dynamic images were stored（the images of patients with coronary atherosclerotic disease were stored before operation and at 6 months after operation）, which lasted three to five consecutive cardiac cycles. The parameters were obtained using offline Qlab 7.0 software： maximal systolic displacement（Ds） of every annulus, systolic displacement of the middle point（D-mid）, longitudinal fractional shortening（FSL）, then the mean of Ds, D-mid and FSL were calculated respectively. The parameters of TMAD between normal controls and the CAD group were compared. Correlation analysis of parameters of TMAD and LVEF were made. Results Compared with normal controls, LAd, LVd, LVEDV and LVESV in CAD group increased [（3.43±0.17） cm vs（3.66±0.21） cm,（4.60±0.23） cm vs（4.89±0.43） cm,（82.51±6.22） ml vs（88.47±9.71） ml,（25.81±3.81） ml vs（38.90±7.24） ml], while LVEF [（64.75±3.43） % vs（56.41±7.17） %] decreased（ t=-3.24,-2.67,-2.60,-6.50 and 5.53, P〈0.05）. At 6 months after operation, LAd, LVd, LVEDV and LVESV [（3.57±0.18） cm,（4.76±0.31） cm,（86.86±8.69） ml,（37.08±8.31）
出处
《中华医学超声杂志（电子版）》
CSCD
2015年第8期635-640,共6页
Chinese Journal of Medical Ultrasound(Electronic Edition)
关键词
冠状动脉疾病
超声心动描记术
二尖瓣
心室功能
左
Coronary atherosclerotic heart disease
Echocardiography
Mitral valve
Ventricular function, left
