摘要
目的应用三维斑点追踪超声心动图(3D-STE)评价冠心病缺血心肌与梗死心肌的应变,探讨其在评价左室心肌缺血严重性中的价值。方法对40例冠心病患者(冠心病组,其中心绞痛20例、心肌梗死20例)及2O例体检正常者(对照组)进行3D-STE检测,得出左室整体纵向应变(GLS)、环周应变(GCS)、径向应变(GRS)、面积应变值(GAS)及各节段纵向应变(LS)、环周应变(CS)、径向应变(RS)、面积应变值(AS)的收缩期峰值,并以冠脉造影(CAG)检测结果为金标准,分析各心肌应变参数与心肌缺血严重性的关系。结果与对照组对比,冠心病组的左室整体应变(GLS、GCS、GRS及GAS)均降低(P<0.05)。与CAG检测结果比较,左室前壁AS判断心肌严重缺血的最佳截断值、敏感性、特异性及AUC分别为-13.8%、95.0%、95.0%、0.9。结论 3D-STE定量分析梗死心肌和缺血心肌的应变,能够反映心肌缺血的严重程度;节段AS可能是定量评价心肌缺血严重性的良好指标。
Objective To assess the value of strains of ischemic and infarcted myocardium for reflecting the severity of left ventricular myocardial ischemia by using three-dimensional speckle tracking echocar-diography（3D-STE）in patients with coronary heart disease（CHD）.Methods The 3D-STE was performed in 40 patients with CHD（CHD group,20 patients with angina pectoris and 20 patients with myocardial infarction）and 20 normal subjects（control group）to obtain the left ventricular global and segmental lon-gitudinal strain（LS）,circumferential strain（CS）,radial strain（RS）and area strain（AS）.The relationship between myocardial strain parameters and severity of myocardial ischemia was analyzed using coronary angiography（CAG）as the gold standard.Results Compared with control group,left ventricular global strain（GLS,GCS,GRS and GAS）,especially anterior and anteroseptal LS,RS and AS,significantly de-creased in CHD group（P〈0.05）.Compared with CAG results,optimal truncation value,sensitivity,spe-cificity and AUC of left ventricular anterior wall AS for judging severe myocardial ischemia were-13.8%,95.0%,95.0% and 0.9,respectively.Conclusion Quantitative analysis of strains of is-chemic and infarcted myocardium with 3D-STE can reflect the severity of myocardial ischemia. Segmental AS may be a good indicator for assessing the severity of myocardial ischemia.
出处
《实用临床医学（江西）》
CAS
2016年第10期58-61,共4页
Practical Clinical Medicine
基金
深圳市龙华新区科技计划项目(1030099)
关键词
三维超声心动图
斑点追踪
应变
心肌梗死
心肌缺血
three-dimensional echocardiography
speckle tracking
strain
myocardial infarction
myocardial ischemia
