脉冲组织多普勒成像技术评价左前降支内支架置入术后左心室局部功能

Evaluation of regional myocardial function after coronary stenting pulsed wave Doppler tissue imaging

目的:应用脉冲组织多普勒成像(PW-DTI)技术评价冠状动脉左前降支(LAD)支架置入术前后左心室心肌局部收缩、舒张功能的变化。方法:采用PW-DTI技术,对26例IAD单支病变并行支架置入术的患者分别于术前1-3天,术后第7、30天检测左心室12节段的局部心肌运动速度,即收缩期峰值速度(Sm)、舒张早期峰值速度(Em)和舒张晚期峰值速度(Am),比较支架置人术后LAD对应节段的Sm、Em、Am以及Em/Am比值的变化。结果:LAD4个对应节段(前壁和前间隔)的Sm在术后第7天时较术前显著增高(P<0.05),并在术后30天时进一步增高;大部分对应节段的Em在术后第7、30天时较术前增高。非LAD对应节段中,仅个别节段的速度测值在支架置入术前后有显著差异。结论:冠脉内支架置入术后早期左心室心肌局部收缩、舒张功能均有显著改善。PW-DTI技术通过检测局部室壁运动速度,能够客观地评价冠状动脉内支架置入术的疗效。

Objective: To assess the regional systolic and diastolic function of left ventricle before and after coronary stent implantation by pulsed wave Doppler tissue imaging (PW-DTI). Methods: Twenty-six patients with coronary artery disease ( CAD) involving only left anterior descending coronary artery ( LAD) were examined within 1-3 days before, 7 days and 30 days after coronary stenting with PW-DTI. Peak systolic , peak early diastolic, and peak late diastolic motion velocities ( Sm, Em, and Am respectively) were measured at 6 different sites on the basal and medial segments corresponding to the anteroseptal, postero-septal, lateral, anterior, inferior, and posterior walls of the left ventricle. Results:In corresponding segments depending on LAD blood flow supply, Sm was increased significantly 7 days after the stenting proce- dure. Em was also increased 7 days after the procedure in most of the corresponding segments. There were little changes in other segments that were independent on LAD blood flow supply. Conclusion: These findings suggest that there is an early improvement in the regional systolic and diastolic function of the left ventricle after the coronary stenting, and that PW-DTI techniques could evaluate quantitatively the regional ventricular performance in patients receiving percutaneous coronary intervention.