定量组织速度成像技术对冠心病心肌缺血的研究

Evaluation of ventricular regional function in coronary heart disease by quantitative tissue velocity imaging

目的运用定量组织速度成像技术(QTVI)测定冠心病患者病变血管相应节段心肌室壁运动速度,评价局部心肌收缩和舒张功能。方法选择38例冠心病住院患者,通过冠脉CT或冠脉造影检查证实冠脉狭窄≥50%,病变血管共59支。其中左前降支(LAD)病变22例,回旋支(LCX)病变19例,右冠(RCA)病变18例。健康对照组20例。所有冠心病患者行冠脉CT或冠脉造影检查前均行普通超声(包括二维、M型及解剖M型超声)检查和心肌定量组织速度成像(QTVI)检查,分别比较结果。结果与健康对照组相比,冠心病组病变血管相应心肌节段室壁的舒张晚期心肌运动速度(Va)差异无统计学意义,右室侧壁收缩期峰值运动速度(Vs)无明显降低。而左室收缩期峰值运动速度(Vs)、舒张早期心肌运动速度(Ve)及Ve/Va均显著降低(P<0.05)。普通超声心动图检测38例冠心病患者结果显示正常者11例,占29%,而以上患者经组织速度成像显示心室各节段Ve、Ve/Va及左室的Vs均有明显降低。结论QTVI能够直观、定量的显示心室局部缺血心肌收缩和舒张功能异常。

Objective To evaluate the clinical value of quantitative tissue velocity imaging QTVI in the detection of regional ventricular systolic and diastolic functions in patients with coronary heart disease. Methods 38 hospitalized patients were diagnosed as coronary heart disease by coronary artery CT or angiography. 59 lesions were found in 114 coronary arteries, and they were divided into three groups：left anterior descending branch group （22 cases） ,left circumflex branch group（ 19 cases） and right coronary artery branch group（ 18 cases）. The control group involved 20 healthy subjects, Myocardial motion velocity was measured with QTVI. Results There were significant differences in peak early diastolic velocity（Ve） , ratio of peak early/late diastolic velocity（Ve/Va） and left ventricular systolic velocity（Vs） between the patients and the healthy subjects. And 11 patients who were examined normally by echocardiogram showed abnormality of regional systolic and diastolic function by QTVI. Conclusion QTVI can detect regional myocardial systolic and diastolic function quantitively in ischemic myocardium.