速度向量成像技术对冠心病患者颈总动脉弹性和运动同步性的评价

Assessment of carotid elasticity and dyssynchrony in patients with coronary heart disease with velocity vector imaging

目的应用速度向量成像技术(VVI)评价颈动脉形态学正常的冠心病患者颈总动脉弹性及运动同步性。方法选择颈动脉形态学正常的疑似冠心病患者90例,根据CAG结果分为正常组(30例)、CAG阳性组[单支病变亚组(27例)及多支病变亚组(33例)]。采集右侧颈总动脉短轴二维图像,运用VVI脱机软件分析,测得血管短轴6个壁最大运动速度(Vmax)、最大应变(Smax)、最大应变率(SRmax)及最大位移(Dmax),并测量血管各壁的径向速度(Tvr)、环向应变(Tsc)、环向应变率(Tsrc)、径向位移(Tdr)达峰时间的标准差(Tvr-SD、Tsc-SD、Tsrc-SD、Tdr-SD)及最大差值(Tvr-max、Tsc-max、Tsrc-max、Tdr-max)。结果①多支病变亚组颈总动脉各壁Vmax、Smax、SRmax、Dmax均小于正常组及单支病变亚组(P<0.05);②单支及多支病变亚组Tvr-SD、Tsc-SD、Tsrc-SD、Tdr-SD、Tvr-max、Tsc-max、Tsrc-max及Tdr-max均大于正常组(P<0.05)。结论 VVI技术是检测颈总动脉弹性和运动同步性的可靠方法,可评价冠心病患者颈总动脉硬化的早期改变。

Objective To assess the alteration of carotid elastic properties and dyssynchronous arterial expansion during systole in coronary heart disease（CHD） without carotid atherosclerotic plaque.Methods Totally 90 patients with suspected coronary artery disease were divided into normal group（n=30） and CAG positive group included single lesion subgroup（n=27） and multivessel lesions subgroup（n=33） respectively,according to the results of CAG.Transverse images of right common carotid arteries were obtained and divided into 6 segments.The maximum value of velocity（Vmax）,strain（Smax）,strain rate（SRmax） and displacement（Dmax） of the six segments were obtained and analyzed,and the standard deviation（Tvr-SD,Tsc-SD,Tsrc-SD and Tdr-SD） and maximum difference（Tvr-max,Tsc-max,Tsrc-max and Tdr-max） of the time to peak radial velocity（Tvr）,circumferential strain（Tsc）,circumferential strain rate（Tsrc） and radial displacement（Tdr） of the 6 segments,which represented dyssynchrony of arterial expansion during systole,were calculated.Results ①Smax,Vmax,SRmax and Dmax value of multivessel lesions subgroup were less than those of the normal group and the single lesion subgroup（P0.05）.②Tvr-SD,Tsc-SD,Tsrc-SD,Tdr-SD,Tvr-max,Tsc-max,Tsrc-max,Tdr-max of single and multivessel lesions subgroups were larger than those of the normal group（P0.05）.Conclusion Arterial assessment using VVI is a reliable method for quantifying vascular alteration noninvasively,and dyssynchronous arterial expansion is a sensitive marker of early arterial aging.