摘要
目的:应用心肌分层应变技术(layer-specific strain,LSS)评价无室壁运动异常的冠心病患者经皮冠状动脉(冠脉)介入治疗(percutaneous coronary intervention,PCI)术后远期左室心肌收缩功能变化。方法:随机选取2017年3月至2018年1月上海市胸科医院行冠脉造影并同期行PCI术的冠心病患者54例为PCI组,冠脉造影阴性者46例为对照组。所有患者均在PCI术前及术后(21.04±2.27)个月采集左室心尖两腔、三腔、四腔心切面的动态图像,应用LSS获取左室心内膜下、中层、心外膜下心肌收缩期整体纵向应变(GLSendo、GLSmid、GLSepi),并计算左室心肌纵向应变的跨壁梯度(ΔGLS)。结果:术前PCI组患者与对照组相比,GLSendo、GLSmid、GLSepi均明显减低(均P<0.05)。随访(21.04±2.27)个月后,术后PCI组GLSendo、GLSmid、GLSepi均较术前PCI组明显升高(均P<0.05),但仍均低于对照组(均P<0.05)。3组间比较,术前PCI组ΔGLS最低,与对照组比较差异有统计学意义(P<0.05),且术后PCI组ΔGLS较术前明显升高(P<0.05)。结论:PCI术后远期左室各层心肌纵向应变均较术前明显改善,且心内膜下心肌收缩功能较心外膜下心肌恢复好。LSS能更敏感、准确地评估无室壁运动异常的冠心病患者PCI术后远期左室心肌收缩功能的变化。
Objective:To evaluate the long-term left ventricular systolic function in patients with coronary artery disease(CAD)witout abnormal wall motion after percutaneous coronary intervention(PCI)by layer-specific strain(LSS).Methods:From March 2017 to January 2018,54 patients with CAD and PCI operation at the same time in Shanghai Chest Hospital were prospectively included(PCI group),and 46 cases with normal coronary artery angiography constituted the control group.Echocardiography was performed before operation and(21.04±2.27)months after PCI.Layer-specific strain was performed in three apical views to provide global longitudinal peak systolic strains(GLS)in the endocardium,mid-myocardium,and epicardium(GLSendo,GLSmid,and GLSepi).The difference between GLSendo and GLSepi(ΔGLS)was calculated.Results:Patients in the preoperative PCI group had significantly lower GLS compared with those in the control group(all P<0.05).After(21.04±2.27)months of follow-up,GLSendo,GLSmid,and GLSepi in the PCI group were significantly higher than those in the preoperative PCI group(all P<0.05),but still lower than those in the control group(all P<0.05).Among the three groups,ΔGLS was the lowest in the preoperative PCI group(P<0.05),and theΔGLS in the postoperative PCI group was significantly higher than that in the preoperative PCI group(P<0.05).Conclusions:The GLS of left ventricle is significantly improved after PCI,and the recovery of GLSendo is better than GLSepi.LSS can sensitively and accurately evaluate the long-term changes of left ventricular systolic function in patients with CAD without abnormal wall motion after PCI.
作者
顾淑莲
吴卫华
谢晓奕
陈璐
郭丽娜
马兰
GU Shu-lian;WU Wei-hua;XIE Xiao-yi;CHEN Lu;GUO Li-na;MA Lan(Department of Ultrasound,Shanghai Chest Hospital,Shanghai Jiao Tong University,Shanghai 200030,China)
出处
《中国临床医学》
2021年第3期497-501,共5页
Chinese Journal of Clinical Medicine
基金
上海市卫生健康委员会课题面上项目(201540143)。
关键词
二维斑点追踪技术
分层应变
冠心病
经皮冠状动脉介入术
左室收缩功能
two-dimensional speckle tracking imaging
layer-specific strain
coronary artery disease
percutaneous coronary intervention
left ventricular systolic function
