解剖M型技术评价PTCA及支架置入术后左室室壁运动

Evaluation on Left Ventricular Wall Motion after PTCA and Stent Implantation with Anatonmic M-Mode Techniques

目的应用解剖M型超声心动图(AMM)评价经皮腔内冠状动脉成形术(PTCA)及支架置入术前后左室室壁运动的改变。方法全组45例,为进行冠状动脉左前降支(Left anterior descending,LAD)PTCA及支架植入的患者,在术前72h、术后72h及3个月时分别进行超声心动图检查,AMM测量左室短轴基底段(二尖瓣水平)和中段(乳头肌水平)前间隔、前壁的收缩期增厚率及室壁运动幅度。结果45例患者术后72 h及3个月检查显示,LAD对应节段(前壁和前间隔)的收缩期增厚率及室壁运动幅度均较术前显著增高(P<0.05,P<0.01)。结论PTCA及支架置入术能迅速改善狭窄冠状动脉供血区域的室壁运动。采用AMM测量对应室壁节段的收缩期增厚率及室壁运动幅度能准确评价PTCA及支架置入术的疗效。

Objective To evaluate the changes of left ventricular（LV） wall motion before and after percutaneous transluminal coronary angioplasty（PTCA） and stent implantation with anatomic M-mode echocardiography （AMM）. Method There were 45 patients with left anterior descending（LAD） coronary artery disease who accepted PTCA and stent implantation. They were studied by AMM 72 hours before and 72 hours,3 months after the operation. The wall thickening fractions and motion amplitude of anterior ventricular septum and anterior wall in basal segment and midpiece of left ventricular minor axis were measured. Results Compared with those before PTCA, the wall thickening fractions and motion amplitude of LAD con＇espondent sgements significantly increased both 72 hours and 3 months after the operation（ P 〈 0.05, P 〈 0.01 ）. Conclusions The wall motion in blood-supplying regions of stenotic coronary artcry could be obviously improved after a successful PTCA and stent implantation. AMM can quantitatively evaluate the efficacy of PTCA and stent implantation by measuring systolic thickening fractions and motion amplitude of correspondent segments of ventricular wall.