斑点追踪成像技术评价非心肌梗死性冠心病患者左室应变及扭转运动的价值研究

Assessment of left ventricular twist and strain in patients with non-infarction coronary heart disease using speckle tracking imaging

目的应用二维斑点追踪成像(STI)技术评价非心肌梗死性冠心病患者左室应变及扭转运动的特点和规律。方法选取未发生心肌梗死的冠心病患者30例(冠心病组)和正常成人30例(正常组),应用STI技术分析左室二维应变、二尖瓣水平旋转角度及旋转率、心尖水平的旋转角度及旋转率、左室整体扭转角度及扭转率。结果冠心病组与正常组比较,基底水平及乳头肌水平的前室间隔、前壁,心尖水平的前室间隔、前壁、后室间隔收缩期纵向峰值应变降低(P<0.05);心尖水平前间隔、前壁的收缩期圆周峰值应变降低(P<0.05);基底水平前室间隔、前壁,乳头肌水平前壁的收缩期径向峰值应变降低(P<0.05);左室整体扭转角度及扭转率,心尖及瓣环水平的旋转角度及旋转率绝对值均较正常组降低,其中左室整体扭转率组间比较差异有统计学意义(P<0.05)。结论非心肌梗死性冠心病患者相应节段心肌的应变及扭转运动已受到影响,应用二维STI技术可以准确评价非心肌梗死性冠心病患者的左室应变及扭转运动,为临床诊断冠心病提供有价值的参考。

Objective To evaluate the characteristics and rules of left ventricular strain and twist in patients with non- infarction coronary heart disease （CHD） using 2D speckle tracking imaging （2D-STI）. Methods Non-infarction coronary heart disease group （n=30） and normal group （n=30） were selected. Left ventricular two-dimensional strain, rotational angle and rotational rate of the mitral valve and apex, and left ventricular torsion angle and torsion rate were analyzed by 2D-STI.Results Compared with normal group, systolic longitudinal strain peak values in anterior septum and anterior wall of the base level and papillary muscle level, and anterior septum, anterior wall and posterior septum of the apical level were decreased in CHD group （P 〈 0.05）. Systolic circumferential strain peak values in anterior septum and anterior wall of the apex level were reduced in CHD group （P 〈 0.05）. Systolic radial strain peak values in anterior septum and anterior wall of the basal level and anterior wall of the papillary muscle level were decreased in CHD group （P 〈 0.05）. The absolute value of whole torsion angle and rate of left ventricle, and torsion angle and rate in the apex and valve ring level were lower than those in normal group. There was significant difference in whole torsion rate of left ventricle between the two groups. Conclusion The strain and torsion motion of the corresponding segments in the patients with non-infarction CHD have been affected. Left ventricular strain and torsion in patients with non-infarction CHD can be accurately evaluated using 2D-STI, which provides a valuable reference for clinical diagnosis of CHD.