| 摘要: |
| 目的： 旨在应用二维斑点追踪(2D-STI)右心室长轴应变参数评价左心室下壁心肌梗死(INFMI)患者经皮冠状动脉介入术(PCI)治疗后的右心室收缩功能恢复情况,评估右心室重构情况以及相关的影响因素。
方法： 36例在我院进行PCI并随访的急性INFMI患者。右心室重构定义为PCI术后3-6个月时右心室舒张末面积与入院时相比，增量大于或等于20%，将患者分为重构组和非重构组。在以右心室为中心的心尖四腔观切面分别用2D-STI技术追踪游离壁和间隔壁获得相应各节段应变值，并测量右心室传统功能参数。
结果： 入院时、出院时以及3-6个月时INFMI患者只有右心室长轴应变参数对比均有差异（P＜0.05）。入院时，重构组LVEF及TAPSE较非重构组测值更低；出院时，重构组RVGLS、RVSEPLS、间隔壁各节段长轴应变绝对值、LVEF以及TAPSE测值均较非重构组更低；3-6个月后，重构组只有RVFWLS、游离壁各节段长轴应变绝对值较非重构组更低，RVEDA和RVESA测值较非重构组更大，差异均有统计学意义（P均＜0.05）；重构组与非重构组比较，只有间隔壁各节段应变恢复趋势有差异（P均＜0.05），表现为非重构组短期恢复较快，但是中远期时重构组逐渐恢复至与非重构组趋于相同水平。
结论： 传统右心室评价参数与2D-STI技术评价右心室收缩功能各有所长，但是应用2D-STI右心室二维应变参数能够更精细反应INFMI患者右心室缺血性功能损伤的程度，以及术后随访的恢复情况。此外，右心室重构发生与否与间隔壁应变恢复程度有关，间隔壁恢复较慢者更容易发生右心室重构。 |
| 关键词: 超声心动描记术 心室功能,右 心肌梗死 心室重构,右 |
| DOI： |
| 投稿时间：2019-01-31修订日期：2019-01-31 |
| 基金项目:中央高校基本科研业务费专项资金科研项目 |
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| Evaluation of the right ventricular systolic function recovery and right ventricular remodeling after percutaneous coronary intervention in patients with inferior wall myocardial infarction by speckle track imaging |
| Yao Xue,Tan tuantuan,Song Hongning,Chen Jinling,Zhou Qing,Guo Ruiqiang,Hu Bo |
| () |
| Abstract: |
| Objective The aim of the study is to evaluate the recovery of the right ventricular systolic function and the remodeling of the right ventricle after percutaneous coronary intervention (PCI) in inferior wall infarction patients by using 2-dimensional speckle tracking imaging (2D-STI) longitudinal strain (LS) parameters and to explore the prevalence and determinants of the right ventricular remodeling.
Methods 36 patients diagnosed with inferior wall myocardial infarction (IWMI) and treated with percutaneous coronary intervention were included and followed up in our study. Right ventricular 2D longitudinal strain (LS) and traditional parameters were then analyzed off line. RV remodeling was defined as an increase in RV end-diastolic area ≥20% from baseline to 6 months follow-up. And patients were then divided into remodeling group and non remodeling group.
Results Only right ventricular LS parameters showed significant difference between different following time. On admission, LVEF and TAPSE were lower in remodeling group than in the non-remodeling group, at discharge, RVGLS,RVSEPLS, septal LSs , LVEF and TAPSE were lower in remodeling group, at 3-6months following, RVFWLS, free wall LSs were lower, RVEDA was larger in the remodeling group (P＜0.05, respectively). Compared with the non-remodeling group, only differences of the recovery trends of all the septal LSs were significant (P＜0.05, respectively), manifesting that septal LSs in non-remodeling group recovered more rapidly than in the remodeling group.
Conclusions The 2D-STI RVLS parameters precisely reflected the impaired RV systolic function in the INFMI patients and appeared to be superior to traditional echocardiographic parameters for the risk stratification of the INFMI patients. Moreover, the recovery of the septum appeared to be associated with the right ventricular remodeling, the slower the septum recovered, the more the right ventricular prone to remodeled. |
| Key words: 2D speckle tracking imaging right ventricular function myocardial infarction right ventricular remodeling |
