| 摘要: |
| 目的 探讨组织二尖瓣环位移(TMAD)技术在不同病变程度冠心病患者左心房功能评价中的应用价值。方法 根据冠脉病变的Gensini评分将88例疑诊冠心病的患者进行分组：Gensini评分=0分为对照组（30例），Gensini评分0～25分为轻度病变组（30例），Gensini评分≥25分为中重度病变组（28例）。首先采用双平面Simpson法获取左房总射血分数（LATEF）、被动射血分数（LAPEF）和主动射血分数（LAAEF），运用TMAD技术获取左房充盈期位移（TMAD-D）、被动射血期位移（TMAD-P）和左房收缩期位移（TMAD-S），并比较3组的差异。然后分析TMAD-D与LATEF、TMAD-P与LAPEF、TMAD-S与LAAEF的相关性以及TMAD参数与Gensini评分的相关性。最后绘制ROC曲线并探讨TMAD参数对中重度冠脉病变的诊断价值。结果 与对照组相比，轻度病变组的LATEF、LAPEF、TMAD-D、TMAD-P减小，中重度病变组的LATEF、LAPEF、LAAEF、TMAD-D、TMAD-P、TMAD-S减小，与轻度病变组相比，中重度病变组的LATEF、LAPEF、LAAEF、TMAD-D、TMAD-P、TMAD-S减小（P均<0.05）。病变组TMAD-D与LATEF、TMAD-P与LAPEF、TMAD-S与LAAEF均呈正相关，r分别为0.856、0.847、0.774，P均<0.001。病变组TMAD-D、TMAD-P、TMAD-S与Gensini评分均呈负相关,r分别为-0.765、-0.551、-0.531，P均<0.001。TMAD-D、TMAD-P、TMAD-S诊断中重度冠脉病变的曲线下面积（AUC）分别为0.951、0.841、0.835，P均<0.001。结论 TMAD技术可简便、可靠地评价不同病变程度冠心病患者的左心房功能，同时为无创评价冠脉病变严重程度提供一定临床价值。 |
| 关键词: 冠状动脉疾病 心房功能 组织二尖瓣环位移 超声心动描记术 |
| DOI： |
| 投稿时间：2022-12-25修订日期：2023-01-31 |
| 基金项目: |
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| Application value of tissue mitral annular displacement in evaluating left atrial function in coronary heart disease patients with different levels of coronary artery lesions |
| zhang yupei,peng yongquan,wang wenyuan,peng xuelian,yang xiaoyan,li wenlan,xia jizhu |
| () |
| Abstract: |
| Objective To explore the application value of tissue mitral annular displacement technique (TMAD) in evaluating left atrial function in coronary heart disease patients with different levels of coronary artery lesions.Methods According to Gensini score based on the coronary angiography results, 88 patients with suspected coronary heart disease were divided into control group(Gensini score =0，n = 30), mild lesion group（Gensini score 0～25，n = 30）and moderate to severe lesion group（Gensini score ≥25，n = 28）. Firstly, left atrial total ejection fraction（LATEF）,left atrial passive ejection fraction（LAPEF） and left atrial active ejection fraction（LAAEF）were obtained by biplane Simpson method. Left atrial filling period displacement（TMAD-D）, left atrial passive ejection period displacement（TMAD-P）and left atrial systolic period displacement（TMAD-S）were obtained by TMAD technique . The differences among the three groups were compared. Then, the correlation between TMAD-D and LATEF, TMAD-P and LAPEF, TMAD-S and LAAEF，and the correlation between TMAD parameters and Gensini score were analyzed. Finally, the ROC curve was drawn and the diagnostic value of TMAD parameters for moderate to severe coronary artery disease was discussed.Results Compared with the control group, LATEF, LAPEF,TMAD-D and TMAD-P in the mild lesion group decreased, LATEF, LAPEF, LAAEF, TMAD-D, TMAD-P and TMAD-S in the moderate to severe lesion group decreased , compared with the mild lesion group, LATEF, LAPEF, LAAEF, TMAD-D, TMAD-P and TMAD-S in the moderate to severe lesion group decreased (all P <0.05). In the lesion group, TMAD-D and LATEF, TMAD-P and LAPEF, TMAD-S and LAAEF were positively correlated (r = 0.856, 0.847,0.774 , respectively, all P <0.001). In the lesion group, TMAD-D, TMAD-P and TMAD-S were negatively correlated with Gensini score (r = -0.765,-0.551 and -0.531, respectively, all P <0.001). The area under the curve(AUC)of TMAD-D, TMAD-P and TMAD-S in the diagnosis of moderate to severe coronary artery disease were 0.951, 0.841 and 0.835, respectively (all P <0.001). Conclusion TMAD technique is a simple and reliable method to evaluate left atrial function in coronary heart disease patients with different levels of coronary artery lesions, and it can provide certain clinical value for non-invasive evaluation of the severity of coronary artery disease. |
| Key words: Coronary artery disease Atrial function Tissue mitral annular displacement Echocardiography |
