多普勒成像检测冠脉内支架置入术后左室肌局部功能变化

Detecting the Change of Regional Myocardial Function after Coronary Stent Implantation by Doppler Tissue Imaging

目的:应用组织多普勒成像(DTI)检测冠状动脉支架置入术前后左室心肌局部收缩、舒张功能的变化。方法:采用脉冲DTI技术,对48例冠心病并行支架置入术的患者分别于术前1～3 d.术后7 d、30 d检测左室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),比较支架置入术前后对应节段的Sm、Em、Am以及Em/Am比值的变化。结果:术后30 d LVEF较术前明显增加(P<0.05);大多数对应节段的Sm于术后7 d已明显增高,且随时间的延长进一步增加,以LAD与LCX对应节段为显;术后30 d时,全部对应节段的Sm、Em及Am均较术前显著增高(P<0.05).而绝大多数对应节段的Em/Am比值在治疗前后无显著变化(P>0.05)。结论:冠脉内支架置入术后早期左室心肌局部收缩、舒张功能均有显著改善。通过DTI检测局部室壁运动速度可用以评价冠脉内支架置入术的疗效。

Objective： To detect the changes of regional systolic and diastolic function of left ventricular myocardium after coronary stent implantation by Doppler tissue imaging（DTI）. Methods：Forty-eight patients with coronary artery disease（CAD）were examined with pulsed wave DTI within 1 -3 days before,7 days and 30 days after coronary stenting. Peak systolic, peak early diastolic,and peak late diastolic motion velocities （Sm, Em, and Am respectively）were measured at different sites on the basal and medial segments corresponding to the anteroseptal, posteroseptal, lateral, anterior, inferior, and posterior walls of the left ventricle. Results： LVEF was increased significantly 30 days after stenting. In most corresponding segments ,Sm was increased significantly（P〈0.05） 7 days after the stenting procedure, which was more obvious in corresponding segments of LAD and LCX. Sm, Em and Am were significantly increased（P〈0. 05） respectively in all corresponding segments 30 days after the stenting, but there were little changes on Em/Am in most segments. Conclusion： These findings suggested that there was an early improvement in the regional systolic and diastolic function of the left ventricular myocardium after the coronary stent implantation,and that DTI techniques could evaluate the effects of percutaneous coronary intervention by detecting quantitatively the regional ventricular performance.