缺血心肌区域性纵向应变与圆周向应变特点

Characteristics of territorial longitudinal and circumferential strain of ischaemic myocardium

目的探讨缺血心肌区域性纵向应变及圆周向应变的特点。方法根据冠状动脉造影结果将42例冠心病患者分为对照组(冠状动脉狭窄率<50%)和缺血组(冠状动脉狭窄率>75%)。利用二维斑点追踪成像技术测量两组患者左心室各个节段的纵向应变和圆周向应变,将冠状动脉每支血管灌注范围内各节段应变的平均值作为区域性应变,并将两组的区域性应变进行对比研究。结果在42例冠心病患者中,对照组19例,缺血组23例。缺血组病变血管灌注范围的区域性纵向应变和圆周向应变均小于对照组相应血管灌注范围的区域性纵向应变和圆周向应变(P<0.05)。结论区域性应变是识别缺血心肌的一个较为稳定和可靠的指标。

Objective The territorial longitudinal and circumferential strain of ischaemic myocardium were investigated. Methods A total of 42 patients were classified into two groups with coronary anglograms ： the control group （ with normal coronary arteries or diameter decrease of 〈 50% in the coronary arteries） and the ischemic group （with diameter decrease of 〉 75% ）. The longitudinal and circumferential strain of each left ventricle segment were measured at rest using two-dimension speckle-tracking echocardiography, and segmental values were averaged to territorial values according to the coronary distribution areas. The difference of territorial strain between two groups was statistically analysed. Results Of 42 patients, 23 had more than 75% of stenosis （isehemic） and 19 had normal coronary anatomy or less than 50% of stenosis （control）. Compared with the control group, the territorial longitudinal （ P 〈 0.01 ） and circumferential strain（ P 〈 0.05 ） in ischemic group were statistiealy significantly decreased. Conclusion Territorial strain is a reliable parameter for detection of ischaemic myocardium.