实时超声造影在评价冠心病患者左室整体与局部心功能中的价值

Value of real-time contrast echocardiography in evaluation of global and regional left ventricular function in patients with coronary artery disease

目的:探讨实时超声造影在评价冠心病患者左室整体与局部心功能中的价值。方法:对22名行冠脉旁路移植手术的患者进行实时心肌造影,分别于超声造影前后观察心内膜边界显示情况,评价节段室壁肌运动情况,测量左室射血分数并与X线左室造影测量结果进行比较。结果:超声造影后左室心内膜边界显示较造影前明显清晰,显示不清的节段减少,清晰显示的节段增多,记分指数增高(P<0.05)。造影前测量的左室射血分数与X线左室造影结果比较差异显著(P<0.05),相关性较低((r=0.46,P<0.05);造影后测量的左室射血分数与X线左室造影结果无显著差异(P>0.05),且相关良好(r=0.87,P<0.01)。在对节段室壁运动异常的检测中,以冠状动脉造影结果为标准,造影后检测灵敏度、特异度和准确度均高于造影前,分别为73.4%、70%、71.9%和55.2%、45.6%、50.9%(P<0.05)。结论:实时超声造影能有效增强左室心内膜边界显示和心肌显影,提高对左室整体和节段心功能检测的准确性。

Objective：To investigate the value of real time contrast echocardiography in evaluation of global and regional left ventricular function in patients with coronary artery disease. Methods： Twenty-two patients receiving coronary artery bypass grafting（CABG） surgery were enrolled in this study. Before and after real-time contrast echocardiography, the left ventricular endocardial border, was delineated; the left ventricular ejection fraction （LVEF） was measured and the regional wall motion was assessed. LVEF results were compared with X-ray opacification reports. Results： After contrast enhancement, the endocardial border became more precise. The number of unclear endocardial border decreased while the number of clear border and the score index increased. The LVEF measured by echocardiography before contrast was significantly different from X-ray results（P〈0.05）, with a poor correlation （r=0.46, P〈0.05）. After contrast enhancement, the difference between these 2 methods became insiginificant（P〉0.05） ,with a good correlation （r=0.87 ,P〈0.05）. Meanwhile, the sensitivity, specificity and accuracy of echocardiography in detecting regional wall motion abnormalities were higher with contrast than those without （73. 4%, 70% ,71.9% and 55.2% ,45.6%, 50.9%, respectively）. Conclusion： Real-time contrast echocardiography can more precisely delineate left ventricular endocardial border and enhance the myocardial opacification,improving the accuracy in detection of the global and regional left ventricular function.