摘要: |
摘 要 目的 应用速度向量成像技术(VVI)分析冠状动脉粥样硬化性心脏病(以下简称冠心病)单支血管病变患者左室各节段收缩期纵向速度峰值的变化特点,评价其左室节段性收缩功能。方法 选取单支冠状动脉病变冠心病患者(冠心病组)和年龄相匹配正常对照组各3 2例。冠心病患者均经冠状动脉造影证实,管腔狭窄率为50% ~90%。冠心病组按狭窄部位不同分为:左前降支组(16例)、左回旋支组(7例)及右冠状动脉组(9例)。所有受检者行超声心动图检查,取心尖四腔心、两腔心及心尖三腔心长轴切面18个节段的动态图像,测量并比较其相应左室18个节段收缩期纵向速度峰值。结果 与正常对照组比较,3个冠心病组(左前降支组、左回旋支组及右冠状动脉组)狭窄冠状动脉所支配的部分节段心肌的收缩期纵向速度峰值明显降低,差异均有统计学意义(均P<0.05)。 结果记录如下(对照组均值±标准差,厘米/秒:冠心病组均值±标准差,厘米/秒):(1)左前降支组(n=16)包括前壁基底段4.96 0.45,cm/s :3.88 0.25,cm/s ; 中间段2.92 0.44,cm/s : 2.20 0.21,cm/s ; 前间隔基底段4.99 0.41,cm/s : 3.90 0.35,cm/s 和 中间段2.97 0.44,cm/s :2.23 0.21,cm/s。 (2)左回旋支组(n = 7) 包括侧壁基底段4.95 0.43,cm/s:4.18 0.26,cm/s和中间段2.95 0.42,cm/s : 2.20 0.27,cm/s。(3)右冠状动脉组(n = 9) 包括下壁基底段4.94 0.45,cm/s:3.76 0.42,cm/s和中间段2.96 0.42,cm/s : 2.02 0.33,cm/s。正常对照组收缩期纵向速度峰值自基底向心尖均呈梯度递减,VVI三维速度成像图呈对称的“V”字形,左前降支组、左回旋支组及右冠状动脉组三维速度成像图室壁对称性消失。结论 应用VVI技术测量心室收缩期纵向速度峰值有助于评估单支冠状动脉狭窄所致的左室壁节段性收缩功能改变。 |
关键词: 速度向量成像 冠状动脉粥样硬化性心脏病 收缩功能 收缩期纵向速度峰值 |
DOI: |
投稿时间:2017-03-31修订日期:2018-03-10 |
基金项目:湛江市科技攻关计划项目(编号:2015B01073) |
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Clinical Value of Quantitative Assessment of Left Ventricular Systolic Function in Patients with single-vessel coronary heart disease by Velocity Vector Imaging |
zhangkang,xiejun |
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Abstract: |
ABSTRACT Objective To analyze the peak systolic longitudinal velocity in patients with single-vessel coronary atherosclerotic heart disease (CHD) by velocity vector imaging (VVI) for assessment of left ventricular (LV) segmental systolic function. Methods 32 patients with single-vessel CHD (CHD group) and 32 age-matched control subjects were enrolled in our study. All the CHD patients with a single-vessel coronary lumen stenosis 50%-90% underwent coronary arteriography. According to the different location of the coronary lumen stenosis, the 32 CHD patients were divide into three groups: left anterior descending artery (LAD) group (n = 16), left circumflex artery (LCX) group (n = 7) and the right coronary artery (RCA) group (n = 9). The dynamic images of 18 LV segments were acquired from all CHD patients and control subjects via the standard echocardiographic views of apical four-chamber, two-chamber and apical left ventricular long axis. The corresponding values of peak systolic longitudinal velocity of 18 LV segments were measured and compared.Results Compared to the control group, the values of peak systolic longitudinal velocity obtained from regional myocardium with corresponding coronary artery stenosis in three CHD groups(LAD group,LCX group and RCA group) are significantly decreased (P<0.05 ).The values of peak systolic longitudinal velocity were recorded as Control group (mean ± SD,cm/s ) vs CHD group (mean ± SD,cm/s) in following three groups: (1) LAD group (n = 16) including basal anterior segments( 4.96 0.45,cm/s vs 3.88 0.25,cm/s), middle anterior segments ( 2.92 0.44,cm/s vs 2.20 0.21,cm/s),basal anteroseptal segments(4.99 0.41,cm/s vs 3.90 0.35,cm/s) and middle anteroseptal segments(2.97 0.44 ,cm/s vs 2.23 0.21,cm/s). (2) LCX group (n = 7) including basal anterolateral segments(4.95 0.43 ,cm/s vs 4.18 0.26 ,cm/s) and middle anterolateral segments(2.95 0.42,cm/s vs 2.20 0.27,cm/s). (3) RCA group (n = 9) including basal inferior segments(4.94 0.45,cm/s vs 3.76 0.42,cm/s) and middle inferior segments(2.96 0.42,cm/s vs 2.02 0.33,cm/s) .In addition, in the control group, the values of peak systolic longitudinal velocity displayed as a gradient decrease from the basal to the apical segment, and the VVI three-dimensional(3D) imaging as a symmetrical "V" shape. These characteristic changes were not shown in LAD, LCX and RCA CHD group. Conclusion Measurements of peak systolic longitudinal velocity via VVI provide a useful method for evaluating the segmental left ventricular systolic function in patients with single-vessel coronary heart disease. |
Key words: Velocity Vector Imaging coronary atherosclerotic heart disease Systolic Function peak systolic longitudinal velocity |