【摘要】 目的应用脉冲组织多普勒 (PW -DTI)技术检测冠脉内支架置入术后早期左室局部功能的变化。方法选取32例冠状动脉疾病患者 ,分别在冠脉内支架置入术前1～3d ,术后7d、30d检测12节段的局部心肌运动速度 ,比较置入支架后冠脉的对应节段的收缩期峰值速度 (Sm)、舒张早期峰值速度(Em)、舒张晚期峰值速度 (Am)及Em/Am在术前、术后的变化 ,以差值>20%为有意义的变化。结果大多数对应节段的Sm在术后7d,Em在术后30d较术前显著增高 (P<0.05)。在总计164个对应节段中 ,Sm、Em、Am增高的节段数于术后7d分别为84(51% )、48(29% )、31(19 % ) ,于术后30d分别为100(61% )、93(57 % )、29(18% )。结论冠脉内支架置入术后早期心肌局部收缩、舒张功能均有显著改善 ,且收缩功能改善早于舒张功能。PW -DTI技术是一种无创评价冠脉内支架置入术早期疗效的有效方法。更多还原

【Abstract】 Objective To assess the early effect of coronary stent implantation on the regional systolic and diastolic function of the left ventricle through the regional myocardial velocities determined by pulsed wave Doppler tissue imaging(PW_DTI).Methods Thirty_two patients(19men and13women,mean age70.38±7.79years)with coronary artery disease(≥50%luminal narrowing)were examined within1～3days before,7days after and30days after coronary stent implantation by using PW-DTI.Peak systolic,peak early diastolic,and peak late diastolic moˉtion velocities(Sm,Em,and Am respectively)were recorded at6different sites on the basal and medial segments corˉresponding to the anteroseptal,posteroseptal,lateral,anterior,inferior,and posterior walls of the left ventricle.In adˉdition,the left ventricular ejection fraction and conventional Doppler diastolic parameters(E/A)were measured in all patients.A failure to increase/decrease velocities>20%was considered as lack of significant changes.Results In most corresponding segments,there was a significant increase in Sm at7days and in Em at30days.In all the164segments related to coronary stent implantation,there were84(51%),48(29%),and31(19%)segments with increased velocities>20%for Sm,Em,and Am respectively at7days,whereas there were100(61%),93(57%),and29(18%)respectively at30days.Conclusions These findings suggested that there was an early improvement in the regional systolic and diastolic function of the left ventricle after the stenting procedure,and that PW-DTI techniques could noninvasively evaluate the regional ventricular function in patients receiving percutaneous coronary intervention.更多还原