节点文献
二维斑点追踪技术评价冠心病患者缺血心肌的应变、旋转和扭转的研究
Assessment of Ischemia Myocardial Systolic Strain,Rotation and Torsion in Patients with Coronary Artery Disease by 2D Speckle Tracking Imaging
【摘要】 目的应用二维斑点追踪显像技术评价冠心病患者缺血心肌的应变、旋转和扭转,并了解随冠脉病变加重,缺血心肌收缩期各应变及缺血节段扭转角度的变化。方法 31例经冠状动脉造影确诊为冠心病患者,按供血冠脉病变狭窄程度将缺血心肌分为两组,即狭窄<70%缺血心肌组(137节段),狭窄≥70%缺血心肌组(174节段)。正常对照组21例,共357个心肌节段。使用EchaoPAC工作站对其进行应变分析,得到纳入研究668个心肌节段圆周应变、径向应变、纵向应变及旋转角度,并计算相应节段扭转角度。结果冠心病组缺血心肌节段纵向、径向、圆周收缩期峰值应变均值较正常组降低,且差异有统计学意义(纵向应变:-21.06±2.26 vs-17.47±2.92、-14.91±2.91;圆周应变-22.29±3.50 vs-19.72±6.99、-15.75±3.90;径向应变:24.52±9.89 vs 20.95±7.53、15.97±2.61,P均<0.05);冠心病组缺血心肌节段扭转角度均值较正常组降低,且差异有统计学意义(P<0.05)。冠脉病变越重、病变支数越多,狭窄冠脉所支配缺血心肌节段纵向、径向、圆周收缩期峰值应变均值及扭转角度越低。应用ROC曲线计算二维应变参数诊断冠心病缺血心肌节段的AUC以纵向应变最高。在截断值为-17.58%时灵敏度为93%,特异度为52%。结论 2D-STI能准确评价冠心病患者左室局部收缩功能异常;局部心肌纵向应变、圆周应变、径向应变和扭转角度可反映冠脉狭窄严重程度。
【Abstract】 Objective To access strain,rotation and torsion of ischemia myocardium in patients with coronary artery disease(CAD) by 2D speckle tracking imaging(2D-STI),and to explore the changes of the strain,rotation and torsion in different graded coronary artery stenosis.Methods Thirty-one patients with CAD were entrolled into this study and twenty-one healthy volenteers in the control groups(357 segments).According to stenosis degree of coronary artery,the affected myocardiums were divided into two groups:<70%group(137 segments),≥70%group(174 segments).2D strain software was used to calculate the radial strain(RS),circumferential strain(CS),longitudinal strain(LS),rotation and torsion at three levels of the shorts axis views(mitral valve,papillary muscle and cardiac apex view)and apical 4-chamber view,apical 2-chamber view and long axis view in the same cardiac cycle.Results Compared with control group,the RS,CS,LS,and torsion were lower in CAD group,the differences were significan(LS:- 21.06±2.26 vs 17.47 ± 2.92,-14.91 ± 2.91;CS:-22.29 ± 3.50 vs-19.72 ± 6.99,-15.75 ± 3.90;RS:24.52 ± 9.89 vs20.95 ± 7.53,15.97 ± 2.61,P<0.05).With the further impairment of coronary artery stenosis and the number of the stenosis vessels,these values became lower.The AUC of the LS was biggest.And when the cut off value was— 17.58%,the sensitivity was 93%,the specificity was 52%respectively.Conclusions Systolic dysfunction of left vertricular regional myocardium in patients with CAD could be accurately analyzed by 2D-STI.The decreased vaules of the RS,CS,LS and torsion could reflect the severity degree of coronary artery stenosis.
【Key words】 Speckle tracking imaging; Cornary artery disease; Strain; Torsion;
- 【文献出处】 中国超声医学杂志 ,Chinese Journal of Ultrasound in Medicine , 编辑部邮箱 ,2014年07期
- 【分类号】R541.4
- 【被引频次】45
- 【下载频次】195