| 摘要: |
| 目的 探讨二维斑点追踪技术(two-dimensional speckle tracking echocardiography 2D-STE)在评估合并右冠状动脉狭窄的冠心病 (coronary artery disease, CAD)患者右室功能改变中的价值。方法 拟诊为冠心病的患者137例,进行常规超声心动图及组织多普勒超声检查。使用2D-STE测量右室游离壁整体峰值纵向应变(global longitudinal peak strain, GLS)、游离壁及室间隔侧基底段、中间段及心尖段收缩期纵向峰值应变(longitudinal peak systolic strain, ε)、右室收缩期峰值应变率(peak systolic strain rate, SRs)、舒张早期峰值应变率(peak early diastolic strain rate, SRe)及舒张晚期峰值应变率(peak late diastolic strain rate, SRa)。根据冠脉造影结果及是否合并右冠状动脉狭窄,分为对照组(A组,冠脉狭窄＜50%)、冠心病不合并右冠状动脉狭窄组(B组)及冠心病合并右冠状动脉狭窄组(C组)。结果 三组间RVFAC、TAPSE、LVEF、SV、S’、Em、Am方面比较,差异无统计学意义(P＞0.05)。三组间游离壁侧基底段ε、中间段ε、心尖段ε、游离壁GLS及SRs方面比较,差异均有统计学意义(P＜0.05)。A组与B组在室间隔侧基底段ε及中间段ε比较差异无统计学意义(P＞0.05)。与B组相比,C组的室间隔侧基底段ε及中间段ε减低(P＜0.05)。三组间SRe、SRa及室间隔侧心尖段ε比较无统计学差异(P＞0.05)。结论 合并右冠状动脉狭窄的冠心病患者右室收缩功能已发生亚临床改变,2D-STE可有效评估右室功能障碍,为临床冠心病患者右室功能的早期诊断及预后提供新的参考价值。 |
| 关键词: 冠心病 右冠状动脉狭窄 斑点追踪技术 右室功能 |
| DOI： |
| 投稿时间：2022-01-05修订日期：2022-01-29 |
| 基金项目:湖北省宜昌市医疗卫生科研项目(A20-2-006) |
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| Evaluation of right ventricular function in patients with coronary artery disease with right coronary artery stenosis by Two-dimensional Speckle Tracking Echocardiography |
| Chen Yue,Liu Rong,Dong Zhizhi,Liu Zulin,Shi Douzi |
| (The First College of Clinical Medical Science, China Three Gorges University & Yichang Central People''s Hospital) |
| Abstract: |
| Objective To discuss the value of Two-dimensional Speckle Tracking Echocardiography (2D-STE) in evaluating the change of right ventricular function in patients with coronary artery disease (CAD) complicated with right coronary artery stenosis. Methods Conventional echocardiography and Tissue Doppler ultrasonography were performed in 137 patients suspected with CAD. 2D-STE was used to measure the global longitudinal peak strain (GLS) of the right ventricle, the longitudinal peak systolic strain (ε), the peak systolic strain rate (SRs), the peak early diastolic strain rate (SRe) and peak late diastolic strain rate (SRa) of the free wall and ventricular septal side for basal, mid, and apical segment. According to the results of coronary angiography and whether there was right coronary artery stenosis, they were divided into control group (group A, coronary artery stenosis < 50%), CAD group without right coronary artery stenosis (group B) and CAD group with right coronary artery stenosis (group C). Results There were no significant differences in RVFAC, TAPSE, LVEF, SV, S’, Em and Am among the three groups (P > 0.05). There were significant differences in free wall basal, mid, apical ε, free wall GLS and SRs among the three groups (P < 0.05). There was no significant difference between group A and group B in the basal and mid segment ε of the ventricular septum (P > 0.05). Compared with group B, the basal and mid segment ε of ventricular septum was decreased in group C (P < 0.05). There were no significant differences in SRe, SRa and ventricular septal apical ε among the three groups (P > 0.05). Conclusions Right ventricular systolic function in CAD patients with right coronary artery stenosis has undergone subclinical changes. 2D-STE can effectively evaluate right ventricular dysfunction, providing new reference value for the early diagnosis and prognosis of right ventricular function in clinical CAD patients. |
| Key words: coronary artery disease right coronary artery stenosis speckle tracking echocardiography right ventricular function |
