| 摘要: |
| 目的 探讨无创左室压力-应变环（left ventricular pressure-strain loop，LV-PSL）定量评估冠心病（coronary artery disease，CAD）患者经皮冠状动脉介入治疗（percutaneous?coronary?intervention,PCI）前后心肌做功的应用价值。
方法 选取2019年11月至2020年5月在徐州医科大学附属连云港医院择期行PCI治疗的CAD患者30例为病例组和同期健康体检者30例为对照组进行前瞻性研究。应用改良双平面Simpson法评估左室舒张末期容积（left ventricular end-diastolic volume， LVEDV）、左室收缩末期容积（left ventricular end-systolic volume，LVESV）及左室射血分数（left ventricular ejection fraction，LVEF），二维斑点追踪超声心动图（two dimensional speckle tracking echocardiography，2D-STE）心肌自动功能成像（automated functional imaging ，AFI）模式评估左室整体纵向应变（global longitudinal strain，GLS），无创LV-PSL评估左室整体做功指数（global myocardial work index，GWI）、整体有效做功（global myocardial constructive work，GCW）、整体无效做功（global myocardial wasted work，GWW）和整体做功效率（global myocardial work effificiency，GWE），比较对照组与病例组术前、术后3天各组间参数的差异及变化。
结果 与对照组相比，病例组PCI术前、术后3天LVEDV、LVESV、GWW明显升高（P ＜0.05），LVEF、GLS、GWI、GCW、GWE明显降低（P ＜0.05）；与PCI术前相比，术后3天GWW明显降低（P ＜0.05），GWE明显升高（P ＜0.05），而LVEDV、LVESV、LVEF、GLS、GWI、GCW无明显变化（P ＞0.05）。GWI、GCW、GWW、GWE与LVEF及GLS均显著相关（P =0.00）。
结论 无创LV-PSL技术可用于定量评估CAD患者PCI治疗前后左室心肌做功，为准确评价CAD对心肌功能的影响以及PCI术后短期内心肌功能的恢复效果提供一种新方法。 |
| 关键词: 左室压力-应变环 心肌做功 冠心病 经皮冠状动脉介入治疗 |
| DOI： |
| 投稿时间：2020-07-07修订日期：2020-09-03 |
| 基金项目: |
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| Quantitative assessment of myocardial work in patients undergoing percutaneous coronary intervention (PCI) by non-invasive left ventricular pressure-strain loop |
| zhangpengying,xueting,chenyunan,renfei,yuanchunmiao,yuming,zhangjie |
| (the Affiliated Lianyungang hospital of Xuzhou Medical University) |
| Abstract: |
| Objective:To explore the application value of?non-invasive left ventricular pressure-strain loop (LV-PSL) in quantitative assessment of myocardial work before and after percutaneous coronary intervention (PCI) in patients with coronary artery disease（CAD）.
Methods: thirty CAD patients who were scheduled to undergo PCI in the Affiliated Lianyungang hospital of Xuzhou Medical University between November 2019 to April 2020 were selected as the case group and 30 healthy subjects in the same period were selected as the control group for the prospective study. The left ventricular end-diastolic volume (LVEDV), left ventricular end-systolic volume (LVESV) and left ventricular ejection fraction (LVEF) were calculated by modified biplane Simpson method. The left ventricular global longitudinal strain (GLS) was measured using two-dimensional speckle tracking echocardiography（2D-STE）myocardial automated functional imaging (AFI). The left ventricular global myocardial work index (GWI), global myocardial constructive work (GCW), global myocardial wasted work (GWW) and global myocardial work effificiency (GWE) were assessed by non-invasive LV-PSL , and to compare the differences and changes of parameters between the control group and the case group before and 3 days after surgery.
Results: Compared with the control group, the LVEDV, LVESV and GWW of the case group were significantly increased before and 3 days after PCI (P < 0.05), and the LVEF, GLS, GWI, GCW and GWE were significantly decreased (P < 0.05); compared with the pre-PCI group, the GWW was significantly decreased and GWE was significantly increased 3 days after PCI (all P < 0.05), while the LVEDV, LVESV, LVEF, GLS, GWI and GCW had no significant changes (P > 0.05). GWI, GCW, GWW, GWE were significantly correlated with LVEF and GLS (P = 0.00).
Conclusion: Non-invasive LV-PSL technology can be used to quantitatively evaluate left ventricular myocardial work in CAD patients before and after PCI, and provide a new method to accurately evaluate the effect of CAD on myocardial function and the recovery effect of myocardial function in the short term post-PCI. |
| Key words: left ventricular pressure strain loop myocardial work coronary artery disease percutaneous coronary intervention |
