斑点追踪技术测量二尖瓣环运动评价冠心病患者左室收缩功能

Assessment of left ventricular systolic function in patients with coronary artery disease by using speckle tracking imaging to measure the mitral annular movement

目的应用斑点追踪技术(speckle tracking imaging,STI)测量二尖瓣环位移,进而评价冠心病患者左心室收缩功能。方法对冠心病26例(冠心病组)及健康者28例(对照组),应用STI测量二尖瓣环4个位点的收缩期峰值位移(S后、S侧、S前、S下)、两切面瓣环连线中点最大位移(AP4-Mid、AP2-Mid)、两切面Mid与左室舒张末最大纵径比值(AP4-Mid%、AP2-Mid%)及4位点收缩期最大位移达峰时间(T后、T侧、T前、T下),分别求均值,并将上述参数与心尖双平面Simpson法计算出的左心室射血分数(LVEF)做相关性分析。结果①与对照组相比,冠心病组4位点S、两切面Mid、Mid%及其均值降低,差异有统计学意义(P<0.01);4位点T及其均值延长,差异有统计学意义(P<0.05或P<0.01);②S后、S侧、S前、S下及S均值与LVEF具有相关性(r=0.643,r=0.633,r=0.623,r=0.720,r=0.806;P<0.01);AP4-Mid、AP2-Mid及Mid均值与LVEF具有相关性(r=0.669,r=0.732,r=0.787;P<0.01);AP4-Mid%、AP2-Mid%及Mid%均值与LVEF具有相关性(r=0.716,r=0.747,r=0.819;P<0.01);T后、T侧、T前、T下及T均值与LVEF呈负相关,但相关不显著(r=-0.376,r=-0.285,r=-0.380,r=-0.272,r=-0.404;P<0.05或P<0.01)。结论 STI可以便捷、准确地评价冠心病患者左心室收缩功能。

Objective Measuring the mitral annular movement to assess the left ventricular systolic function in patients with coronary artery disease （CAD） by speckle tracking imaging （STI）.Methods STI was performed on 26 patients with CAD （group CAD） and 28 healthy subjects（control group）.To obtain such parameters as maximal systolic displacement （S） of septal,lateral,ante-rior and inferior mitral annulus （Ssep,Slat,Sant,Sinf）,systolic displacement of the middle point （Mid） on apical four/two chamber view （ AP4-Mid,AP2-Mid） ,their ratio to the length of left ventricle at end-diastolic （ AP4-Mid%,AP2-Mid%） and the time to peak systolic displacement （T） of the four points of mitral annulus （Tsep,Tlat,Tant,Tinf）.Then,the mean of those were calculated.Moreover,the cor-relation between such STI parameters and left ventricular ejection fraction （ LVEF） measured by biplane Simpson methods were ana-lyzed.Results ①Compared with control group,Ssep,Slat,Sant,Sinf,AP4-Mid,AP2-Mid,AP4-Mid%,AP2-Mid% and the mean of S, Mid,Mid%were decreased significantly （P〈0.01 for all）,Tsep,Tlat,Tant,Tinfand the mean of T were increased significantly （P〈0.05 or P〈0.01） in group CAD.②Ssep,Slat,Sant,Sinf and the mean of S correlated well with LVEF （r=0.643,r=0.633,r=0.623,r=0.720,r=0.806;P〈0.01）; AP4-Mid,AP2-Mid and the mean of Mid correlated well with LVEF （ r=0.669,r=0.732,r=0.787;P〈0.01）;AP4-Mid%,AP2-Mid%and the mean of Mid% correlated well with LVEF （ r=0.716,r=0.747,r=0.819;P〈0.01）;Tsep,Tlat,Tant,Tinf and the mean of T also correlated with LVEF （r=-0.376,r=-0.285,r=-0.380,r=-0.272,r=-0.404;P〈0.05 or P〈0.01）.Conclusion STI can conveniently and accurately assess left ventricular systolic function in patients with CAD .