摘要
目的探讨分析应用二维斑点追踪显像(2D-STI)技术评价冠状动脉慢性完全性闭塞(CTO)患者经皮冠状动脉介入术(PCI)后左心室应变情况的效果。方法纳入2017年9月~2018年5月于阜外心血管病医院超声科经冠状动脉造影明确为CTO并成功施行PCI的患者43例为CTO组(n=43),另选取同期于本院进行体检的30例健康志愿者作为对照组(n=30)。CTO组患者分别于PCI前1 d、后1月及后3个月行超声心动图检查,对照组于体检当天行超声心动图检查:常规超声测量舒张早期二尖瓣血流速度(E)与舒张晚期二尖瓣血流速度(A)比值(E/A)、左心室舒张末期容积(LVEDV)、收缩末期容积(LVESV)、左心室射血分数(LVEF)及舒张早期二尖瓣环运动速度(e');采集胸骨旁左室短轴二尖瓣、乳头肌、心尖水平动态图像,以及心尖部四腔观、两腔观及三腔观动态图像,应用2D-STI技术分析左心室分层纵向应变参数及左心室整体纵向、径向及圆周应变参数(GLS、GRS及GCS)。结果术前,CTO组E/e’值较对照组明显升高(P<0.05);与PCI前及后1月比较,CTO组术后3个月E/e’值明显降低(P<0.05)。与对照组相比,CTO组术前左心室整体应变(GLS、GCS、GRS)均显著降低,PCI后1个月GLS较术前升高(P<0.05),术后3个月GLS、GCS及GRS较术前均增高(P<0.05)。与对照组相比,CTO组术前左心室各层心肌纵向应变均显著降低(P<0.05),PCI后1个月及治疗后3个月左室各层应变参数逐渐增高,PCI后3个月时增高更加显著(P<0.05)。结论CTO患者的左心室收缩功能较正常人减低,PCI可明显改善CTO患者心室收缩功能,2D-STI技术能有效评价CTO患者PCI术后左心室应变情况。
Objective To evaluate the effect of two-dimensional speckle tracking imaging(2D-STI)on left ventricular strain after percutaneous coronary intervention(PCI)in patients with chronic complete occlusion(CTO).Methods From September 2017 to May 2018,43 patients with CTO who underwent coronary angiography and PCI were selected as CTO group(n=43).Thirty healthy volunteers who underwent physical examination in the hospital served as the control group(n=30).Echocardiography was performed in the CTO group 1 day before PCI,1 month after surgery,and 3 months after surgery.The control group underwent echocardiography on the day of physical examination:conventional ultrasound measures the early diastolic mitral flow velocity(E)and diastolic mitral flow velocity(A)ratio(E/A),left ventricular end-diastolic volume(LVEDV),end-systolic volume(LVESV),left ventricular ejection fraction(LVEF),and early diastolic mitral Velocity of the annulus(e');horizontal dynamic images of the left ventricular mitral valve,papillary muscle,and apex of the sternum,and four-chamber view,twochamber view and three-chamber view of the apex,and 2D-STI technique The left ventricular stratified longitudinal strain parameters and the left ventricular global longitudinal,radial and circumferential strain parameters(GLS,GRS and GCS)were analyzed.Results Before operation,the E/e'value of the CTO group was significantly higher than that of the control group(P<0.05).Compared with the preoperative PCI and 1 month after operation,the E/e'value of the CTO group was significantly lower after 3 months(P<0.05).Compared with the control group,the total left ventricular total strain(GLS,GCS,GRS)was significantly lower in the CTO group,and the GLS was higher than that in the first month after PCI(P<0.05).GCS and GRS were higher than those before surgery(P<0.05).Compared with the control group,the longitudinal strain of the left ventricle in the CTO group was significantly decreased(P<0.05).The strain parameters of the left ventricle gradually increased 1 month after PCI a
作者
沈艳
骆志玲
王奖
李丽
董云星
赵婉玉
Shen Yan;Luo Zhiling;Wang Jiang;Li Li;Dong Yunxing;Zhao Wanyu(Department of Ultrasound,Fuwai Cardiovascular Hospital,Kunming,Yunnan 650031,China)
出处
《中国循证心血管医学杂志》
2019年第9期1062-1065,1068,共5页
Chinese Journal of Evidence-Based Cardiovascular Medicine
基金
国家自然科学基金(81660052)