超声斑点追踪技术评价冠心病患者经皮冠状动脉介入术后左室的收缩功能

Evaluation of left ventricular systolic function by speckle tracking echocardiography in patients with coronary heart disease after percutaneous coronary intervention

  • 摘要:
      目的  探讨超声斑点追踪技术对冠心病(CAD)患者经皮冠状动脉介入术(PCI)术后评价左室收缩功能的作用。
      方法  选择51例行PCI手术的CAD患者为研究组,选择51例志愿者为对照组。2组应用彩色多普勒超声诊断仪斑点追踪技术检测左室收缩功能,其中研究组分别在PCI术前与术后3个月进行检测,对照组在体检时检测。比较2组左室心室舒张末内径(LVDd)、左心室收缩末内径(LVDs)、二尖瓣口舒张早期峰值血流速度(E)、舒张晚期峰值血流速度(A)、E和A的比值(E/A)、左心室射血分数(LVEF)。分析研究组整体径向应变峰值(GPRS)、整体纵向应变峰值(GPLS)、整体环向应变峰值(GPCS)与LVEF检测变化的相关性。观察2组超声二维斑点追踪显像(STI)曲线与纵向应变牛眼图。
      结果  研究组PCI术前、术后的A高于对照组,E/A与LVEF低于对照组;研究组PCI术后LVEF高于术前;研究组PCI术前、术后GPRS低于对照组,GPLS、GPCS高于对照组;研究组PCI术后GPRS高于术前,GPLS、GPCS低于术前;上述差异均有统计学意义(P < 0.01)。研究组GPRS、GPLS、GPCS与LVEF存在相关性(r=-0.722,-0.545,-0.667,P < 0.05)。PCI术前,STI曲线各节段运动曲线形态幅度不一致,轮廓不规则,明显分离,PCI术后,STI曲线发现各节段运动曲线形态幅度基本一致,曲线已趋于正常;对照组17节段纵向应变牛眼图与运动曲线显示应变曲线轮廓规则,达峰时间统一,波峰波谷一致。
      结论  超声斑点追踪技术可有效评价CAD患者PCI术后左室收缩功能,并具有可重复追踪、方便、无痛苦等优势。

     

    Abstract:
      Objective  To investigate the roles of speckle tracking echocardiography in the evaluation of left ventricular systolic function for patients with coronary artery disease (CAD) after percutaneous coronary intervention (PCI).
      Methods  Fifty-one CAD patients undergoing PCI were selected as study group, and 51 volunteers were selected as control group. The left ventricular systolic function was detected by speckle tracking technology of color Doppler ultrasound diagnostic instrument in the two groups. The study group was detected before PCI and 3 months after PCI, and the control group was detected at physical examination. The left ventricular end diastolic diameter (LVDd), left ventricular end systolic diameter (LVDs), peak early flow velocity (E)in mitral, peak late flow velocity (A), the ratio of E to A (E/A), left ventricular ejection fraction (LVEF) were compared between the two groups before and after PCI. The correlations between global peak radial strain (GPRS), global peak longitudinal strain (GPLS), global peak circumferential strain (GPCS) and LVEF detection changes in the study group were analyzed. Speckle-tracking imaging curve and longitudinal strain bull eye diagram were observed in two groups.
      Results  The A value of the study group before and after PCI was significantly higher, and the E/A and LVEF of the study group were significantly lower than that of the control group (P < 0.01); LVEF after PCI was significantly higher than that before PCI (P < 0.01); the GPRS of the study group before and after PCI was significantly lower, and the GPLS and GPCS of the study group were significantly higher than that of the control group (P < 0.01). GPRS in the study group after PCI was significantly higher, and GPLS and GPCS were significantly lower than before (P < 0.01). GPRS, GPLS and GPCS in the study group were correlated with LVEF (r=-0.722, -0.545, -0.667, P < 0.05). Before PCI, the shape and amplitude of motion curve of each segment of STI curve were inconsistent, and the contour was irregular and obviously separated. The STI curve after PCI showed that the shape and amplitude of motion curve of each segment were basically consistent, and the curve had tended to be normal; in the control group, the contour of strain curve was regular, the peak time was unified, and the peak and trough were consistent.
      Conclusion  Ultrasound speckle tracking technique can effectively evaluate left ventricular systolic function in patients with coronary heart disease after PCI, and has the advantages of repeatable tracking, convenience and painless.

     

/

返回文章
返回