超声二维应变成像评价冠状动脉病变

Evaluation of coronary lesions with two-dimensional strain echocardiography

目的采用超声二维应变成像检测局部心肌功能,准确评价冠状动脉病变。方法67例可疑冠心病患者进行冠状动脉造影,并将患者分为两组:病例组42例,冠状动脉狭窄≥70%;对照组25例,冠状动脉狭窄<50%。在冠状动脉造影前24小时进行超声二维应变成像,比较两组左心室心肌峰值纵向收缩期应变(Ss)和应变率(SRs)、舒张早期应变率(SRe)、舒张晚期应变率(SRa)、SRe/SRa,及达SRe时间(T-SRe)。结果病例组狭窄≥70%冠状动脉所支配心肌的Ss、SRs、SRe和SRe/SRa均小于对照组心肌(P<0.001)。SRs和SRe是冠状动脉狭窄≥70%的独立预测因子,且SRe<0.91预测冠状动脉狭窄≥70%的灵敏性为72.46%,特异性为89.65%。结论二维应变成像可通过检测心肌舒张功能准确诊断冠状动脉病变。

Objective To evaluate the coronary lesions with two-dimensional strain echocardiography. Methods Sixty-seven patients with suspected coronary heart diseases who underwent coronary angiography were divided into two groups. Forty-two of them with coronary stenosis ≥70% were considered as patient group, and the other 25 with coronary stenosis 〈50 % were regarded as control group. Two-dimensional strain was performed in all patients within 24 h before coronary angiography. Longitudinal systolic strain rate （SRs）, early （SRe） and late （SRa） diastolic strain rate, systolic strain （Ss）, and time to SRe （T-SRe） were measured and compared. Results Ss, SRs, SRe and SRe/SRa decreased significantly in regions controlled by coronary artery with ≥70% stenosis in patient group compared with those controlled by coronary artery with 〈50% stenosis in control group. SRs and SRe were the independent predictive factors of coronary stenosis ≥70%, and the sensitivity and specificity of SRe 〈0.91 to identify coronary stenosis ≥70% was 72. 46% and 89. 65%, respectively. Conclusion Two-dimensional strain echocardiography may accurately evaluate the coronary lesions by detecting regional myocardial diastolic function.