摘要
目的应用二维斑点追踪技术(2D-STI)检测左心室心内膜回声增强患者左心室心内膜下心肌应变参数,探讨左心室心内膜回声增强与心肌缺血及冠状动脉病变的关系。方法收集我院经超声心动图检查存在左心室心内膜回声增强患者80例,根据Gensini评分标准分为无病变组(Gensini评分=0分)28例、轻度病变组(0分<Gensini评分<25分)26例及中重度病变组(Gensini评分≥25分)26例。记录各组左心室心内膜回声增强的发生率、左心室心内膜回声增强处心肌节段与病变冠状动脉供血心肌节段的对应率,测量左心室心内膜回声增强厚度及面积;应用2D-STI获取左心室心内膜下心肌整体峰值纵向应变和环向应变(GLSendo、GCSendo)、心尖四腔心峰值纵向应变(AP4LSendo)、心尖三腔心峰值纵向应变(AP3LSendo)、心尖两腔心峰值纵向应变(AP2LSendo)、心内膜回声增强处心内膜下心肌峰值纵向应变和环向应变(LSendo-ee、CSendo-ee)、左心室短轴基底段峰值环向应变(SAXBCSendo)、左心室短轴中间段峰值环向应变(SAXMCSendo)、左心室短轴心尖段峰值环向应变(SAXACSendo),比较各组上述参数的差异。分析左心室心内膜回声增强厚度及面积、左心室心内膜下心肌应变参数与Gensini评分的相关性。绘制受试者工作特征(ROC)曲线分析各参数对中重度冠状动脉病变的诊断效能。结果各组左心室心内膜回声增强的发生率比较,差异无统计学意义。轻度病变组、中重度病变组左心室心内膜回声增强处心肌节段与病变冠状动脉供血心肌节段的对应率均较高(75.0%、72.6%)。与无病变组比较,轻度病变组GLSendo、GCSendo、AP4LSendo、LSendo-ee、CSendo-ee、SAXACSendo、左心室心内膜回声增强厚度均增大,差异均有统计学意义(均P<0.05);与无病变组和轻度病变组比较,中重度病变组GLSendo、GCSendo、AP4LSendo、AP3LSendo、AP2LSendo、LSendo-ee、CSendo-ee、SAXBCSendo、SAXMCS
Objective To measure the strain parameters of the subendocardial myocardium in the left ventricle in patients with endocardial echo enhancement by two-dimensional speckle tracking imaging(2D-STI),and to explore the relationship between the left ventricular endocardial echo enhancement and myocardial ischemia and coronary artery disease.Methods A total of 80 patients with left ventricular endocardial echo enhancement who underwent echocardiography in our hospital were selected.According to the standard of Gensini score,the participants were devided into coronary artery without lesion group(28 cases,Gensini score=0),mild lesion group(26 cases,0<Gensini score<25),and moderate to severe lesion group(26 cases,Gensini score≥25).The incidence of left ventricular endocardial echo enhancement in each group was recorded,as well as the correspondence of the segments supplied by the diseased coronary arteries.The thickness and area of left ventricular endocardial echo enhancement were measured.The global peak longitudinal strain and circumferential strain(GLSendo,GCSendo)of left ventricular subendocardial myocardium,apical 4-chamber peak longitudinal strain(AP4LSendo),apical 3-chamber peak longitudinal strain(AP3LSendo),apical 2-chamber peak longitudinal strain(AP2LSendo),and endocardial echo enhancement site peak longitudinal strain and circumferential strain(LSendo-ee,CSendo-ee),short-axis basal segment peak circumferential strain(SAXBCSendo),short-axis mid-segment peak circumferential strain(SAXMCSendo),and short-axis apical segment peak circumferential strain(SAXACSendo)were obtained by 2D-STI.The differences of the above parameters were compared among the groups.The correlation between left ventricle endocardial echo enhancement thickness and area,left ventriclar subendocardial myocardial strain parameters and Gensini score were analyzed.Receiver operating characteristic(ROC)curve was drawn to analyze the diagnostic efficiency of each parameter in the diagnosis of moderate and severe coronary artery disease.Results Th
作者
胥莹
杨青艳
王世界
王文渊
朱炜薇
凡正超
夏纪筑
XU Ying;YANG Qingyan;WANG Shijie;WANG Wenyuan;ZHU Weiwei;FAN Zhengchao;XIA Jizhu(Department of Ultrasound Medicine,Affiliated Hospital of Southwest Medical University,Sichuan 646000,China)
出处
《临床超声医学杂志》
CSCD
2024年第7期569-577,共9页
Journal of Clinical Ultrasound in Medicine
基金
泸州市科技计划项目(2023SYF113)。
关键词
超声心动描记术
斑点追踪
二维
左心室
回声增强
冠状动脉疾病
Echocardiography
Speckle tracking,two-dimensional
Left ventricle
Echo enhancement
Coronary artery disease
