超声速度向量成像技术在冠心病支架植入术前后左室收缩功能变化定量评价中的应用

Left ventricular function changes evaluated with velocity vector imaging before and after coronary artery stent implantation

目的应用超声速度向量成像（VVI）技术定量评价冠心病患者支架植入术后近期左室收缩功能的变化。方法选取经冠状动脉造影证实的冠心病患者48例（冠心病组）及同期的无心肺疾病者30例（正常对照组），采用VVI技术分别对正常对照组及冠心病组LAD支架植入术前及术后1个月，测量心尖四腔切面[包括后间隔心尖段（A）、中间段（B）、侧壁心尖段（C）]、心尖两腔切面[包括左室前壁心尖段（D）、中间段（E）、基底段（F）]、心尖左室长轴切面[包括前室间隔中间段（G）、基底段（H）]各节段的收缩期峰值速度（Vs）、应变率（SRs）、应变（ε）；同时测量冠心病组患者手术前后的左心室射血分数（LVEF）；然后作比较分析。结果冠心病组术前除A、C节段外，其余各节段Vs、SRs、E均明显低于正常对照组（P〈005或0．01）；冠心病组B、D、E、F、G、H节段中除B节段外，其余节段Vs、SRs、ε在术后1个月均较术前明显增加（P〈0．05或001）；冠心病组患者支架植入前LVEF[（4750±680）％]明显高于支架植入后[（5940±710）％]（P〈0．05）。结论VVI技术可以作为定量评价冠心病支架植入术后近期左室收缩功能变化的一种无创的新方法。

Objective To quantitatively evaluate the ventricular function with velocity vector imaging （VVI） before and after coronary artery stent implantation. Methods The base and mid ventricle systolic peak velocity （Vs）, strain rate （SRs）and strain （ ε ）of the septal and anterior walls were measured in 48 patients with anterior descending （LAD） stenosis（ 75-100% ）1-3d before and 1 month after LAD stent implantation. The left ventricular ejection fraction （LVEF） was measured using Simpson method and the results were compared with those of 30 normal controls. Results Compared with those before LAD stent implantation, the Vs, SRs, ε one month after LAD stent implantation were increased （P〈0.05）. LVEF were 0.475 ± 0.068 and 0.594 ± 0.071 before and after stent implantation, respectively （P〈0.01 ）. Conclusion VVI is a useful method in evaluation of left ventricular systolic function after anterior descending coronary artery stent implantation.