冠状动脉介入治疗后心肌灌注改善对心肌收缩功能影响的斑点追踪成像评价

Myocardial systolic function improvement after perfusion increment with percutaneous coronary intervention assessed by speckle tracking imaging

目的应用斑点追踪成像技术(STI)评价经皮冠状动脉介入治疗(PCI)心肌灌注改善后近期心肌收缩功能的变化。方法26例行PCI的患者,于PCI前、后经冠状动脉注入造影剂Sonovue,应用心肌声学造影(MCE)观察心肌显影效果,定量分析心肌灌注情况;分别于术前及术后5 d应用STI于左心室短轴系列切面测量病变节段径向应变(RS)、圆周向应变(CS)及旋转应变(Rot)评价心肌收缩功能变化,并与正常节段进行对照。结果开通冠状动脉后,MCE显示68．7％的节段灌注好转;STI提示,灌注显著改善节段的RS和CS均显著改善(P值均<0．05),而Rot无明显变化(P>0．05);灌注未显著改善节段的上述指标均无明显变化(P值均> 0．05)。结论PCI术后灌注显著改善的心肌节段近期左心室短轴心肌增厚及缩短运动增强,而旋转运动无改善。

Objective To explore the myocardium perfusion as well as systolic function improvement by intracoronary myocardium contrast echocardiography（MCE） and speckle tracking imaging after percutaneous coronary intervention （PCI）. Methods Intracoronary Sonovue MCE was performed before and after PCI in 26 patients with successful PCI （TIMI flow Ⅲ after PCI）. Myocardial systolic function was evaluated with left ventrieular short axis view speckle tracking imaging before and 5 days after PCI. Results Myocardium perfusion increased significantly after intervention in about 68.7% segments. Successful PCI resulted in circumferential strain and radial strain improvement without rotation enhancement in the ischemic segments when compared to those before inter- vention. However, these parameters did not change in segments without perfusion improvement. Conclusion With the perfusion improvement, thickening and shortening capabilities improved but except the rotation enhancement after PCI.