二维斑点追踪成像技术评价舒张期应变率对冠心病的诊断价值

Evaluation of diagnostic value of diastolic strain rate by two-dimensional speckle tracking imaging in patients with coronary heart disease

目的应用二维斑点追踪成像技术对常规方法显示室壁运动正常的冠心病患者进行定量分析,探讨其临床应用价值。方法采集经冠状动脉造影或CT证实的38例冠心病组和40例对照组患者的心尖长轴、四腔和两腔观的二维灰阶动态图像,测量舒张早期峰值应变率(SrE)和舒张晚期峰值应变率(SrA),应用ROC曲线评价左心室壁各节段SrE/SrA<1对冠心病筛选的特异性和敏感性。结果冠心病组室壁各节段SrE/SrA<1比例明显高于对照组(P<0.01)。以30.6%作为筛选冠心病的临界值,其敏感性为76.7%,特异性为80.0%;以38.5%作为筛选冠心病多支病变的临界值,其敏感性为88.7%,特异性为80.4%。结论二维斑点追踪成像技术中应变率检查,特别是SrE/SrA<1的比例,有助于临床筛选冠心病。

Objective To investigate the clinical value of two-dimensional speckle tracking imaging in the diagnosis of myocardial ischemia with normal ventricular wall motion. Methods According to the results of coronary angiography or CT,38 patients with coronary heart disease（CHD） and 40 age-matched subjects were enrolled. The two dimensional loop-cinec were obtained in apical 4-chamber view,apical 2-chamber view and long axis of left ventricle view. Early strain rate（SrE） and late stain rate（SrA） of diastolic phase were measured. Incidence of SrE/SrA〈1 was applied to evaluate the diagnostic efficiency for CHD by receiver operating curve. Results The average incidence of SrE/SrA〈1 in CHD group was significantly higher than that in control group （P〈 0.01）. Using 30.6% and 38. 5% as the cut values of incidence of SrE/SrA〈1 for diagnosing CHD and multi-coronary artery heart disease respectively,the sensitivity was 76.7% and 88.7% and specificity was 80.0% and 80.4% respectively. Conclusions Two-dimensional speckle tracking imaging,especially the incidence of SrE/SrA〈1 ,is a valuable predictor of CHD.