多普勒组织成像和应变率显像结合评价冠脉搭桥患者术后左心功能的变化

Left ventricular function before and after coronary artery bypass grafting as assessed by Doppler tissue imaging and strain rate imaging

目的运用多普勒组织成像(DTI)和应变率显像技术(SRI)评价冠脉搭桥(CABG)患者术后左心功能的变化。方法对32例患者,分别于CABG术前、术后4周行超声心动图检查。比较常规经胸超声指标、各时相二尖瓣环运动速度(Sa、Ea和Aa)以及室壁局部心肌沿长轴的应变率(SRs、SRir和SRac)的变化。结果术后4周,常规超声指标均有改善,但无统计学意义(P>0.05);二尖瓣环各位点的Sa、室间隔和下壁的Ea、Ea/Aa以及前壁的Ea有明显改善;各室壁的SRs和SRir、前壁的SRac均有明显改善(P<0.05)。结论DTI和SRI相结合,能更好的反映CABG术后左心功能的变化;CABG能改善左心功能,收缩功能的改善优于舒张功能的改善,局部心功能的改善比整体心功能的改善明显。

Objective To evaluate left ventricular function before and after coronary artery bypass grafting （CABG） by using Doppler tissue imaging （DTI） and strain rate imaging （SRI）. Methods Transthoracic echocardiography （TTE） was performed in 32 patients with coronary heart disease （CHD） before and 4 weeks after CABG. Conventional echocardiography parameters were documented. Real time, 2-dimensional color Doppler myocardial imaging （CDMI） data for longitudinal function were recorded from each wall segment and then carried out the off-line analysis of regional velocity and SR. Results At 4-week follow-up, compared with pre-CABG, changes of the conventional echocardlography parameters were found but without statistic significance; mitral annulus peak systolic velocities （Sa） and peak SR in different periods on left ventricular wall improved significantly （P〈0.05）. Conclusion This study indicated that DTI and SRI indexes are superior to conventional echocardiography parameters in detecting ventricular systolic and diastolic function. As assessed by the novel indexes, CABG could improve left ventrlcular function, and more obvious improvement might be found with regional systolic ventricular function than global diastolic function.