应变和应变率成像评价左冠状动脉起源于肺动脉患者左心室局部心肌功能的研究

Study on the evaluation of left ventricular function by strain rate imaging in anomalous origin of the left coronary artery from the pulmonary artery

目的:探讨应变率成像技术评价左冠状动脉起源异常患儿局部心肌功能的临床应用价值。方法:应用应变率成像技术比较16例左冠状动脉起源于肺动脉(Anomalous origin of the left coronary artery from the pulmonary artery,LCAPA)患儿与39例正常儿童左心室不同心肌节段的应变率值以及应变值。结果:对照组平均收缩期峰值应变率(-2.12±0.75)s-1,收缩期应变(-25.24±4.07)%,舒张早期应变率(2.32±0.69)s-1,舒张晚期应变率(1.65±0.61)s-1;病例组平均收缩期峰值应变率(-1.42±0.49)s-1,收缩期应变(-17.56±5.71)%,舒张早期应变率(1.48±0.49)s-1,舒张晚期应变率(0.85±0.42)s-1。病例组收缩期及舒张期应变率及应变均小于对照组,差异有显著意义(P<0.01)。病例组室间隔基底段的应变率值及应变值与其它节段相比较差异有显著意义。病例组基底段收缩期峰值应变率(-2.22±.41)s-1,收缩期应变(-25.24±4.07)%,舒张早期应变率(2.32±0.69)s-1,舒张晚期应变率(1.65±0.61)s-1。结论:应变率成像技术可以评价左冠状动脉起源于肺动脉患者局部心肌功能。

Objective：To explore the clinical value of strain rate imaging（SRI） in quantitative detection of left ventricular function in patients with anomalous origin of the left coronary artery from the pulmonary artery（LCAPA）.Methods：Thirty-nine healthy subjects and 13 children with anomalous origin of the left coronary artery from the pulmonary artery were studied.Regional strain rate in the mid,basal and apical segment in systolic,early diastolic and later diastolic period and the systolic strain were measured,and these data were compared and analyzed.Results：The parameters of peak systolic strain rate（SRs）,peak early diastolic strain rate（SRe）,peak late diastolic strain rate（SRa）and strain in the LCAPA group SRs=（-1.42±0.49） s^-1,averaged epsilon =（-17.56±5.71） %,SRe=（1.48±0.49） s^-1,SRa=（0.85±0.42） s^-1;P 〈0.01 vs normals） were significantly lower than those in the normal group（SRs=（-2.12±0.75） s^-1,averaged epsilon =（-25.24±4.07）%,Sre=（2.32±0.69） s^-1,SRa=（1.65±0.61） s^-1）;The parameters of SRs,SRe,SRa and strain in the basal segment of septal showed statistic difference compared with any other segment in LCAPA group.Conclusion：The new echocardiography techniques of strain rate imaging could accurately detect the abnormal regional myocardial function of anomalous origin of the left coronary artery from the pulmonary artery.