| 摘要: |
| 目的 应用分层应变技术评估急性冠脉综合征（acute coronary syndrome ,ACS）患者PCI术后左室收缩功能的变化。方法 急性起病且首次确诊ACS并接受择期或急诊PCI术治疗的患者44例，正常体检者40例作为对照组；分别采集入组者心尖四腔、两腔、三腔切面及二尖瓣、乳头肌、心尖短轴切面动态图像，连续五个心动周期，应用Echo PAC工作站及分析软件分别获取左心室整体及各节段心内膜下、中层、心外膜下三层心肌的纵向应变（GLSendo、GLSmid、GLSepi、TLSendo、TLSmid、TLSepi）。根据冠脉造影结果筛选出受累节段，并获取其心内膜下、中层、心外膜下三层心肌的纵向应变,并分析相应参数间的差异。结果 与对照组比较，冠心病组左室整体及受累节段各层心肌收缩期纵向应变均低于对照组（P<0.05）；与术前相比，术后左室整体及受累节段各层心肌收缩期纵向应变均有改善，术后3个月、6个月时改善明显（P<0.05）。术后1周各应变参数稍增高，但差异无统计学意义（P>0.05）。结论 ACS患者左心室收缩功能减低，接受PCI术治疗后，左室各层心肌收缩功能均有改善，心内膜心肌应变的恢复程度快于心外膜下层心肌。应用分层应变技术获取的应变参数能准确评价ACS患者PCI术前后左心室局部及整体收缩功能，能有效评估PCI术治疗疗效。 |
| 关键词: 二维斑点追踪 ACS 左室收缩功能 PCI术 |
| DOI： |
| 投稿时间：2017-10-16修订日期：2017-11-18 |
| 基金项目: |
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| Evaluation of left ventricular systolic function in patients with ACS after PCI by stratified strain technique |
| xin kairong,zhou qing |
| (People's Hospital, Wuhan University;Department of Ultrasound Imaging, People's Hospital, Wuhan University) |
| Abstract: |
| Objective To evaluate the changes of the left ventriclar systolic function after PCI in patients with acute coronary syndrome by stratified strain technique. Methods Acute onset and the first diagnosis of ACS and received elective or emergency PCI treatment of patients with 44 cases, 40 cases of normal physical examination as a control group; The apical four-chamber, two-chamber, three-chamber incision and mitral, papillary muscle and apical short-axis dynamic images were used for five consecutive cardiac cycles. Echo PAC workstation and analysis software were used to obtain the longitudinal strain (GLSendo, GLSepi, TLSendo, TLSmidi, TLSepi) of the left ventricular septum in the subendocardial, middle and epicardium. According to the results of coronary angiography, the affected segments were screened and the longitudinal strain of the subendocardial, middle and epicardium were obtained. And analyze the differences between the corresponding parameters. Results Compared with the control group, The whole and segment longitudinal strain of the patients with ACS were significantly lower (P <0.05); Compared with preoperative, the longitudinal strain of the left ventricular septum and the affected segment were improved after operation, and the improvement was significant at 3 months and 6 months (P <0.05). The strain parameters were slightly higher at 1 week postoperatively, but the difference was not statistically significant (P> 0.05) Conclusion The left ventricular systolic function is reduced in patients with ACS, and the myocardial systolic function of the left ventricle is improved after PCI ,endocardial myocardium strain recovery faster than epicardial myocardium.The strain parameters obtained by stratified strain technique can accurately evaluate the local and total systolic function of left ventricle before and after PCI in patients with ACS, which can effectively evaluate the therapeutic effect of PCI. |
| Key words: two-dimensional speckle tracking imaging acute coronary syndrome left ventricular systolic function percutaneous coronary intervention |
