左心室应变和扭转对冠心病患者心脏功能水平的关系研究

Relationship between left ventricular strain and torsion and cardiac function in patients with coronary heart disease

目的 研究左心室应变和扭转对冠心病患者心脏功能水平的关系。方法 选取我院于2016年10月到2017年10月收治的冠心病患者70例,按照纽约临床心功能分级积分(NYHA-P)分为纽约临床心功能分级正常组38例,心功能分级异常组32例,以及再选择体检正常的志愿者30位作为对照组,比较受检者的NYHA-P、左室射血分数(LVEF)、总体心肌整体径向应变(GRS)、纵向应变(GLS)、左室心肌收缩期心肌扭转角度(TA)。结果 冠心病患者组与对照组比较,LVEF、GLS、GRS、TA降低。心功能分级正常组与异常组相比,LVEF、GLS、GRS、TA降低。心功能正常组GLS、GRS、TA与LVEF无相关性,与NYHA-P相关。心功能异常组GLS、GRS、TA与LVEF及NYHA-P都相关。心功能分级异常组以GLS-14.75%截断点判定患者NYHAP积分高于4.5分的灵敏度为87.45%,特异度为72%,Youden指数最高为0.653。结论 左心室应变和扭转与冠心病患者心脏功能水平相关,可以有效评价冠心病患者的临床心脏功能水平。

Objective To study the relationship between left ventricular strain and torsion and cardiac function in patients with coronary heart disease.Methods A total of 70 patients with coronary heart disease who were admitted to our hospital from October 2016 to October 2017 were selected.According to New York clinical heart function classification scores,38 patients with normal heart function classification and 32 patients with abnormal heart function classification were divided into two groups.30 normal volunteers were selected as the control group.The subject's NYHA-P,left ventricular ejection fraction(LVEF),left ventricular total radial strain(GRS),longitudinal strain(GLS),left ventricular systolic myocardium torsion angle(TA)were detected by spot tracking technology compared.Results Compared with the control group,the LVEF,GLS,GRS and TA decreased in patients with coronary heart disease.In the abnormal group.LVEF,GLS,GRS,and TA were lower than those in the normal cardiac function group.There was no correlation between GLS,GRS.TA and LVEF in the normal cardiac function group.but associated with NYHA-P.The GLS,GRS and TA of the cardiac dysfunction group were related both to LVEF and NYHA-P.The sensitivity of the patients with NYHA-P score higher than 4.5 with the GLS-14.75%cut-off point was 87.45%and the specificity was 72%;and the Youden index was 0.653 in the cardiac dysfunction group.Conclusion Left ventricular strain and torsion are related to the level of cardiac function in patients with coronary heart disease.and can effectively evaluate the clinical heart function in patients with coronary heart disease.