超声实时三平面组织同步显像技术在冠心病手术治疗前后左心室收缩期非同步运动中的应用研究

Research on left ventricle systolic dyssynchronicity with tissue synchronization imaging real-time tri-plane echocardiography before and after operation in patients with coronary artery disease

目的在超声实时三平面(tri-plane)下应用组织同步显像(TSI)技术研究冠心病患者行经皮冠状动脉成形术(PTCA)、支架植入术或冠状动脉搭桥术(CABG)治疗前后,左心室各节段心肌非同步运动的改变及其临床意义。方法在超声实时三平面下,采用TSI技术获取40例冠状动脉粥样硬化性心脏病(冠心病)患者的标准心尖四腔观、心尖左室二腔观、心尖左室长轴观的左心室6个壁基底段、中间段和近心尖段共18个位点的心肌纵向收缩期达峰值速度时间(Ts)和峰值速度(Vs)。分析手术前、后心肌纵向收缩期Ts及Vs的变化。结果患者手术前、后左室收缩期同一节段不同室壁(Inter)-Ts、Inter-Vs及左室收缩期同一室壁不同节段(Intra)-Ts、Intra-Vs值比较,差异有统计学意义(P<0.05);手术前、后射血分数(EF)值比较,差异有统计学意义(P<0.05)。结论实时三平面组织同步显像技术能准确评价左心室壁收缩期非同步运动的改变,对评估冠心病患者手术疗效具有重要临床价值。

Objective To evaluate the regional myocardial dyssynchronicity and velocity of left ventricle（LV）with tissue synchronization imaging（TSI） by real-time three-plane echocardiography in the patients with coronary artery disease before and after percutaneous transluminal coronary angioplasty（PTCA）,stent or coronary artery bypass graft（CABG） surgery.Methods Forty patients with coronary artery disease were studied by TSI in real-time tri-plane echocardiography.The regional velocity profiles of 18 segments of LV apical 4 chamber,2 chamber and long-axis view were obtained for measuring and analyzing the alteration of the time to peak velocity and peak velocity（Ts,Vs） during systole before and after operation.Results The Inter-Ts,Intra-Ts,Inter-Vs,Intra-Vs and EF of left ventricle in the patients with coronary artery disease before and after operation had statistically significant difference（P0.05）.The change of LVEF before and after operation had statistical difference（P0.05）.Conclusion Using TSI by real-time tri-plane echocardiography can accurately evaluate the dyssynchronicity of left ventricle during systole and has the important clinical value for assessing the operative effect in the patients with coronary artery disease.