定量组织速度成像对无心肌梗死的冠心病患者左心室收缩非同步性运动的研究

Assessments of Left Ventricular Systolic Asynchrony by Quantitative Tissue Velocity Imaging in the Patients with Coronary Disease without Myocardial Infarction

目的应用定量组织速度成像(quantitative tissue velocity imaging,QTVI)分析不伴心肌梗死的冠心病患者左心室心肌收缩的运动特征,探讨其评价心肌同步运动的价值。方法应用QTVI技术,对72例无心肌梗死的冠心病患者进行超声心动图检查,定量分析左心室心肌各节段收缩峰值速度及达峰时间,并追踪造影结果,根据冠脉造影结果分为4组,A组:冠造阴性组,B组:狭窄程度<50%,C组:50%≤狭窄程度<75%,D组:狭窄程度≥75%,比较组间差异。结果 4组患者左心室壁各节段收缩峰值速度的比较,D组与A组、B组及C组比较差异有统计学意义(P<0.05);同一室壁相邻节段心肌收缩达峰时间差值△Ts1的比较,D组与A组、B组及C组间差异有统计学意义(P<0.05);同一水平不同室壁之间心肌收缩达峰时间差值△Ts2的比较,D组与A组、B组及C组差异有统计学意义(P<0.05)。结论 QTVI作为一种定量分析技术,能够评价不伴心肌梗死而有重度冠脉狭窄患者的左心室收缩非同步运动。

Objective To analyze the motion feature of the left ventricular myocardiumby using quantitative tissue velocity imaging （QTVI） in patients without with coronary disease without myocardial infarction. Methods On conventional two - dimensional echocardio- graphy, 72 patients were examed and underwent coronary angiography within one week. Then quantitatively analyze the left ventricular peak systolic velocity and the time to peak velocity. The patients were classified into four groups（A：without stenosis, B： 〈 50% , C： ~〉 50% and 〈 75% , D： I〉75% ）. Analyze the differences among groups. Results The peak systolic velocity wasreduced in myocardial seg- ments subtended by coronary arteries with greater than 75% stenosis when compared with those subtended by coronary arteries with less than 75% stenosis and without stenosis （P 〈 O. 05 ）. The range of Ts of different segments in same wall （ A T1 ） and the range of Ts of dif- ferent wall in same level（ A T2 ） were respectively reduced in the same inter - groups （P 〈 0.05）. Conclusion QTVI is considered as a technology of quantitative analysis in evaluating left ventricular systolic asynchrony in patients with severe coronary stenosis but without my- ocardial infarction.