摘要
目的应用超声斑点追踪技术(STI)检测冠心病(CAD)患者左室应变及扭转参数,并与纽约心功能分级积分(NYHA-P)进行比较分析,探讨STI定量评估CAD心功能分级的价值。方法随机对70例CAD患者按NYHA-P分为纽约心功能分级正常或接近正常组(40例)及心功能分级异常组(30例),并选择正常对照组(30例),比较受检者NYHA-P、左室射血分数(LVEF)、左室心肌整体径向应变(GRS)、纵向应变(GLS)、左室心肌收缩期心肌扭转角度(TA)。结果 CAD组与对照组比较:LVEF、GLS、GRS、TA减低(P<0.05);心功能正常组与异常组比较:LVEF、GLS、GRS、TA减低(P<0.05);正常组GLS、GRS、TA与LVEF无相关性,与NYHA-P相关;异常组GLS、GRS、TA与LVEF及NYHA-P呈相关性;以GLS-14.65%截断点判定患者NYHAP积分高于4.5分的灵敏度为87.30%、特异度为75%,Yuedden指数最高为0.653。结论 2D-STI技术检测心肌应变及扭转评价CAD左心室局部功能具有独特的优越性,局部应变及扭转参数与左室射血分数不一定相关,但与临床心功能分级相关,应变及扭转评价临床心功能较左室射血分数敏感,可以定量评价CAD患者实际临床心功能状态。
Objective To analyze and compare the relation between left ventricular myocardial strain and torsion detected by using ultrasound speckle tracking technology （STI） with New York Heart Association Points （NYHA- P） in paitents with coronary artery disease （CAD）, then to explore the value of STI in quantitative assessment of NYHA. Methods To randomly divide 70 patients with CAD into normal or near normal group （normal group,40 cases） and cardiac function abnormal group （abnormal group,30 cases） according to NYHA-P, to compare NY- HA-P, left ventricular ejection fraction （LVEF）, left ventricular global radial strain （GRS）, longitudinal strain （GLS）, left ventrieular systolic myocardial twist angle （TA） in all the subjects including 30 healthy volunteers （group C）. Results The LVEF, GLS, GRS and TA were significantly lower in patients with CAD compared with the control group （P 〈 0. 05 ） ; the LVEF, GLS, GRS and TA in normal group were significantly higher when compared with the abnormal group （P 〈 0.05 ） ： GLS, GRS, TA had no correlation with LVEF and had relation with NYHA-P in normal group, but there was positive correlation between GLS, GRS, TA with LVEF or NYHA-P in normal group and abnormal group , GLS-14. 65% as the cut-off point can determine the NYHA-P more than 4.5 points with sensitivity of 87.30%, specificity degree of 75%, the Yuedden highest index was 0. 653. Conclusion The left ventricular myocardial strain and torsion detected by ultrasound speckletraeking technology （STI） has u- nique advantages in evaluating local cardic function, cardial strain and torsion have higher sensitive in quantitatively evaluating clinical heart function in patients with CAD, but they are not necessarily related to left ventricular ejection fraction.
出处
《安徽医科大学学报》
CAS
北大核心
2017年第1期121-124,共4页
Acta Universitatis Medicinalis Anhui
基金
广东省医学科研基金(编号:A2010584)
关键词
冠心病
临床心功能
应变
扭转角度
coronary artery disease
New York Heart Association
strain
torsion angle
