| 摘要: |
| 目的 探讨二维斑点追踪成像技术和心肌声学造影技术在评价冠状动脉慢性完全闭塞（CTO）病变患者经皮冠状动脉介入治疗（PCI）后左室功能的早期恢复中的应用价值。方法 纳入符合条件的拟行PCI血运重建的CTO病变患者39例，分别于PCI血运重建术术前72小时内及术后72小时内行常规二维超声心动图、二维斑点追踪成像、心肌声学造影检查，对各组术前术后数据进行比较。并按所开通冠状动脉不同，将患者分为三组，分别比较上述三支冠状动脉对应供血区域术前术后的局部心肌灌注及局部心肌纵向应变（RLS）有无差异。结果 术后的二尖瓣E峰速度、二尖瓣A峰速度、e′S、e′L、 e′、E/ e′比值、LVEDV、LVESV、LVEF、WMSI与术前相比，差异无统计学意义；术后PSI显著降低；术后GLS、A、β、A·β均较术前显著增加，差异均有统计学意义。在LAD组、RCA组、LCX组三组患者中，CTO患者开通冠状动脉对应供血区域心肌的RLS、PSI、A、β、A·β均较术前明显改善，P值均小于0.05，差异具有统计学意义。结论 PCI血运重建术可以改善CTO患者的心肌灌注和心肌运动功能，心肌声学造影和二维斑点追踪技术均可以早期、定量的评价这一改善，且可以同时评价左室整体和局部的心肌灌注水平和运动功能。 |
| 关键词: 冠状动脉慢性完全闭塞 经皮冠状动脉介入 心肌声学造影 二维斑点追踪成像 左室功能 |
| DOI： |
| 投稿时间：2019-07-11修订日期：2020-01-05 |
| 基金项目: |
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| Evaluation of early efficacy at post-percutaneous coronary intervention in patients with chronic total coronary occlusion by myocardial contrast echocardiography and two-dimensional speckle tracking imaging |
| huangyan,Zhu fang,Ding mingyan,Luan bo,Ji wei,Li ying,Zhang huihui |
| () |
| Abstract: |
| Objective：To investigate the value of two-dimensional speckle tracking imaging and myocardial contrast echocardiography in the evaluation of early left ventricular recovery after percutaneous coronary intervention （PCI） in patients with chronic total occlusion （CTO）.
Methods：A total of 39 patients with CTO lesions who underwent PCI revascularization were enrolled. conventional two-dimensional echocardiography，two-dimensional speckle tracking imaging and myocardial contrast echocardiography were performed within 72 hours pre- and post-PCI revascularization on them，acquiring and saving images，measuring and calculating the left ventricular fuction parameters, Then compared all of the parameters between the pre-PCI and post-PCI. According to the CTO lesions in different coronary vessels were repatency，the patients were divided into three groups，regional myocardial longitudinal strain （RLS） and regional myocardial perfusion（PSI，A，β，A·β） at pre-PCI and post-PCI were calculated and compared respectively. Results At post-PCI，E-peak velocity and A-peak velocity of mitral valve，e ?S，e ?，e ?L，E/e ? ratio，LVEDV，LVESV，LVEF，WMSI were not statistically different from those before PCI. The post-PCI PSI was significantly lower， The GLS，A，β，A·β were significantly increased compared with pre-PCI， the difference was statistically significant. Among the three groups of patients in the LAD group，RCA group and LCX group，the RLS，PSI，A，β，A·β of each coronary artery donated area were significantly improved compared with the pre-PCI，P values were all less than 0.05，the difference were statistical significance. Conclusions PCI revascularization can improve myocardial perfusion and myocardial motor function in patients with CTO lesions. Both myocardial contrast echocardiography and two-dimensional speckle tracking imaging can evaluate the improvement early and quantitatively，and can simultaneously evaluate the left ventricular global and regional myocardium perfusion changes and strain changes. |
| Key words: Coronary chronic total occlusion, Percutaneous coronary intervention, Myocardial contrast echocardiography, Speckle Tracking Imaging, Left ventricular function |
