| 摘要: |
| 目的 应用二维超声斑点追踪成像（2D-STI）技术评价冠状动脉粥样硬化性心脏病（以下简称冠心病）患者左室心肌各方向收缩功能的变化，探讨2D-STI技术对于早期诊断冠心病的临床价值。方法 选取临床疑似冠心病患者138例，依据冠状动脉造影结果分为对照组（68例，未见冠状动脉狭窄）、A组（28例，冠状动脉狭窄率＜50%）、B组（22例，冠状动脉狭窄率50%～75%）和C组（20例，冠状动脉狭窄率≥75%）。应用2D-STI测量左室基底段、中间段、心尖段中各缺血心肌节段的纵向、圆周、径向收缩期应变峰值（BAS-ls、MID-ls、APE-ls、BAS-cs、MID-cs、APE-cs、BAS-rs、MID-rs、APE-rs），并比较各组上述参数的差异。以冠状动脉造影结果为金标准，绘制受试者工作特征曲线（ROC），计算各参数预测冠状动脉狭窄率≥75%的敏感性和特异性。结果 B组APE-ls较正常对照组减低，C组BAS-ls、MID-ls、APE-ls、MID-cs、APE-cs较对照组均减低，差异均有统计学意义（均P＜0.05）；余各组各参数与对照组比较差异均无统计学意义。ROC曲线分析结果显示，各缺血心肌节段的收缩期纵向应变峰值曲线下面积最大（为0.853），以截断值为-17.5%诊断重度狭窄冠心病的灵敏度为83.3%，特异度为71.4%。结论 在无明显左室节段性室壁运动异常的冠心病患者中，缺血心肌节段的收缩功能已经发生不同程度的减低；应用2D-STI技术可定量评价冠心病患者左室收缩功能，进一步推测冠状动脉的狭窄程度，有望成为早期筛查冠心病的新手段。 |
| 关键词: 斑点追踪成像，二维 冠状动脉粥样硬化性心脏病 收缩功能，心室，左 |
| DOI： |
| 投稿时间：2018-10-30修订日期：2019-03-22 |
| 基金项目: |
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| Evaluation of left ventricular myocardial systolic function in patients with coronary atherosclerotic heart disease with different severity of coronary artery stenosis by speckle tracking imaging |
| zhangzihui |
| () |
| Abstract: |
| Objective Evaluation of left ventricularthe myocardium systolic function in patients with coronary atherosclerotic heart disease (coronary heart disease) by two-dimensional speckle tracking imaging (2D-STI) and to evaluate the clinical value of 2D-STI technique in early diagnosis of coronary heart disease.Methods Selection of 138 patients with suspected coronary heart disease,according to the results of coronary angiography, patients were divided into control group (68 cases,without coronary artery stenosis), group A( 28 cases ,coronary artery stenosis rate < 50%), group B(22 cases Coronary artery stenosis rate 50% to 75%) and group C (20 cases, coronary artery stenosis rate ≥ 75%).Measurement of longitudinal, circumferential and radial systolic peak strain of ischemic myocardial segments in left ventricular basal segment, middle segment and apical segment by 2D-STI (BAS-ls,MID-ls,APE-ls,BAS-cs,MID-cs,APE-cs,BAS-rs,MID-rs,APE-rs), and compare the differences of the above parameters among the three groups.Using the results of coronary angiography as the gold standard, the sensitivity and specificity of predicting coronary stenosis rate ≥ 75% the receiver operating characteristic curve were drawn(ROC).Results The APE-ls in group B was lower than that in control group, and the BAS-ls,MID-ls,APE-ls,MID-cs,APE-cs in group C was lower than that in control group (all P＜0 05).The difference between the parameters of the remaining groups and the control group was not statistically significant.The results of ROC curve show that the peak systolic longitudinal strain peak of each ischemic myocardium is the most valuable diagnostic for severe stenosis coronary heart disease, the area of the curve is 0.853, the sensitivity is 83.3%, the specificity is 71.4%, and the cutoff value is -17.5%. Conclusion In patients with coronary heart disease without obvious left ventricular segmental wall motion abnormality, the systolic function of ischemic myocardial segments has been reduced to varying degrees. 2D-STI technique can be used to quantitatively evaluate left ventricular systolic function in patients with coronary heart disease, and further estimate the degree of coronary artery stenosis, which may become a new method for early screening of coronary heart disease. |
| Key words: speckle tracking imaging,two-dimensional coronary atherosclerotic heart disease systolic function, ventricular,left |
