彩色室壁运动技术评价冠脉支架置入术对左室局部舒张功能的影响

To evaluate the effect of intracoronary stent implantation on left ventricular regional diastolic function using Color kinesis

目的 探讨采用彩色室壁运动技术 (CK)评价冠脉支架置入术对左室局部舒张功能的影响。方法 2 6例老年陈旧心肌梗死患者进行CK测量 ,包括 :左室壁各节段全舒张期及前 1 / 3舒张期心内膜位移 (DEM,1 / 3DEM) ,前 1 / 3舒张期心内膜位移分数 (1 / 3DEMF ) ,全舒张期 ,前 1 / 3及后 2 / 3舒张期心内膜位移平均速度 (VDEM,1 / 3VDEM,2 / 3VDEM) ,同时记录 1 / 3充盈分数 (1 / 3FF)。以上根据二维定性方法对运动正常 ,运动减弱和运动消失三种室壁运动状态分别进行测量 ,对比冠脉支架置入术术前、术后 3个月上述的变化。结果 术前 CK测量结果显示 :三种室壁运动状态间的 DEM,VDEM均存在显著性差异 (P <0 .0 1 ) ,且运动正常节段的 1 / 3VDEM显著快于 2 / 3VDEM(P <0 .0 1 )。运动减弱节段的 1 / 3VDEM略快于 2 / 3VDEM(P<0 .0 5) ,运动消失节段的 1 / 3VDEM显著低于 2 / 3VDEM(P<0 .0 1 ) ,且 1 / 3FF和 1 / 3DEMF显高度相关 (r=0 .87,P<0 .0 1 )。冠脉支架置入术术后 3个月左室舒张功能较术前有明显改善 ,表现为 DEM,VDEM的增加 (P <0 .0 5)。结论 彩色室壁运动技术可以定量评价左室局部舒张功能 。

? Objective To evaluate the effect of intracoronary stent implantation (ISI) on left ventricular regional diastolic function using Color kinesis in patients with old myocardial infarction (OMI). Methods 26 patients with OMI underwent CK imaging as following: the diastolic segmental endocardial motion (DEM), DEM of the first third diastolic period (1/3 DEM) and 1/3 diastolic segmental endocardial motion fraction (1/3DEMF), as well as the mean velocity of endocardial motion of the whole diastolic period (V DEM ), the first third diastolic period (1/3 V DEM ) and that of the later two thirds diastolic period (2/3 V DEM ) were measured. Meanwhile the transmittal 1/3 filling fraction (1/3FF) was calculated. We compared CK measurements among 3 wall motion grades (i.e. normal, hypokinetic and akinetic) assessed by quantitative wall motion scoring. All these measurements were performed before ISI and 3 months after ISI. Results There was a significant overall difference in DEM and V DEM (P<0.01) among wall motion grades. 1/3 V DEM was greater than 2/3 V DEM in normal (P<0.01) and hypokinetic (P<0.05) segments, though 1/3 V DEM was slower than 2/3 V DEM in akinetic segments (P<0.01). There was also a close correlation between 1/3 FF and 1/3 DMEF in OMI (r=0.87, P<0.01). The above Doppler echocardiography parameters (DEM, V DEM ) of ventricular diastolic function got a significant improvement (P<0.05) during 3 months after ISI. Conclusions Analysis of color kinesis image can quantitatively assess regional diastolic function. Intracoronary stent implantation can improve left ventricular diastolic regional function during 3 months after the operation.