应变率显像定量评价冠状动脉旁路移植术后左心室局部功能

Assessment of left ventricular regional function after coronary artery bypass grafting by strain rate imaging

目的探讨应变率显像（SRI）技术在评价冠心病患者冠状动脉旁路移植术前后左心室局部功能变化中的应用价值。方法对16例冠心病患者分别于冠状动脉旁路移植术前3d、术后12d及3个月行超声心动图检查，应用SRI技术对左室各壁基底段和中间段的局部心肌功能进行定量分析，共分析192个节段。根据术前二维超声心动图室壁运动情况将心肌节段分为运动正常组（152个节段）和运动异常组（40个节段）。结果术前运动正常组收缩期心肌峰值应变率（SRs）和舒张早期心肌峰值应变率（SRe）与运动异常组相比差异无统计学意义（P〉0．05）。运动异常组术后3个月的房缩期心肌峰值应变率（SRa）较术前3d增高（P〈0．05）。运动正常组术后3个月与术前3d相比，SRs、SRa及SRe均增高（分别P〈0．05和0．01），术后3个月与术后12d相比，SRs增高（P〈O．05）。结论应用SRI技术能定量评价冠状动脉旁路移植术前后左室局部心肌功能的改变。

Objective To investigate the value of strain rate imaging（SRI） in estimating the changes of left ventrieular regional myocardial function in patients with coronary artery disease before and after coronary artery bypass grafting operation. Methods In sixteen patients with coronary artery disease, echoeardiography was performed 3 days before, 12 days after and 3 months after coronary artery bypass grafting operation respectively. SRI was used to quantitatively analyze the regional myocardial function of left ventricular wall. One hundred and ninety two segments of left ventricular myocardium were analyzed in the study. The left ventricular myocardium was divided into segments with normal （ 152 segments） and abnormal（40 segments） wall motion according to two-dimensional echocardiography before the operation. Results Peak strain rate during systolic and early diastolic contraction （SRs, SRe） was not statistically significant between segments with normal and abnormal wall motion before operation. In segments with abnormal wall motion,myocardial peak strain rate of atrial contraction （SRa） was increased three months after operation comparing with three days before operation （ P 〈 0.05）. In segments with normal wall motion, the absolute values of SRs, SRa and SRe were increased three months after operation comparing with three days before operation （P 〈 0.05 and 0.01 ）. SRs was increased three months after operation comparing with 12 days after operation （P 〈0.05）. Conclusions SRI can be used to evaluate the functional changes of left ventricular regional myocardium quantitatively after coronary artery bypass grafting operation.