三维斑点追踪技术评价左室功能下降患者PCI术后的心功能变化

The 3-dimensional speckle tracking imaging assesses left ventricular function in patients with declined left ventricular function after PCI

目的：采用三维斑点追踪新技术评价中度左室功能下降患者PCI术后心功能的变化。方法：对38例冠心病患者PCI术前采用双平面Simposon法测量左室射血分数（LVEF）,筛选出LVEF≤50%患者,对其采用三维斑点追踪技术分别于术前、术后5~7d、1个月、3个月、6个月测量整体长轴应变（GLS）、短轴应变（GRS）、圆周应变（GCS）及面积应变（GAS）。结果：与PCI术前比,PCI术后5~7d[GRS（30.76±8.24）%∶30.47±7.66）%]、[GLS（-12.35±2.10）%∶GLS（-12.41±2.09）%]、[GCS（-11.74±3.66）%∶GCS（-11.76±4.35）%]、[GAS（-22.15±4.16）%∶GAS（-22.17±4.13）%]和EF[（43.45±4.32）%∶EF（43.94±3.66）%]均无明显变化（P〉0.05）。与PCI术前比,患者PCI术后1个月后的[GRS（30.76±8.24）%∶GRS（36.32±9.53）%],[EF（43.45±4.32）%∶EF（47.97±4.51）%]均明显增加,[GLS（-12.35±2.10）%∶GLS（-14.09±2.68）%],明显降低,[GCS（-11.74±3.66）%∶GCS（-14.09±3.02）%],明显降低,[GAS（-22.15±4.16）%∶GAS（-24.71±4.59）%],明显降低,P〈0.05。与PCI术前比,患者PCI术后3个月后的[GRS（30.76±8.24）%∶GRS（37.74±9.68）%],EF[（43.45±4.32）%∶EF（50.20±3.66）%]均明显增加,[GLS（-12.35±2.10）%∶GLS（-14.59±2.92）%],明显降低,[GCS（-11.74±3.66）%∶GCS（-15.21±3.25）%],明显降低,[GAS（-22.15±4.16）%∶GAS（-26.29±4.46）%],明显降低,（P〈0.05）。结论：中重度左室功能下降患者行PCI术后1个月及3个月心功能明显改善,三维斑点追踪可能是评价冠心病患者心功能的新技术。

Objective：To assess effect of 3-dimensional speckle tracking imaging（3D-STI）on transformation of left ventricular function in patients with declined left ventricular function after PCI.Method：Thirty-eight coronary disease patients who had declined left ventricular function（EF≤50%）were enrolled,the myocardial motion was recored and analyzed with 3D-STI.Global longitudinal（GLS）,circumferential（GCS）,radial（GRS）and area strain（GAS）were measured automatically.Result：Compared with pre-operative parameters,after three to five days post-operative,GRS[（30.76± 8.24）% vs（30.47± 7.66）%],GLS[（-12.35 ±2.10）%vs（-12.41 ±2.09）% ],GCS[（-11.74± 3.66）% vs（-11.76± 4.35）% ],GAS[（-22.15 ±4.16）% vs（-22.17±4.13）%]and EF[（43.45±4.32）% vs（43.94±3.66）%].There were no significant transformation（all P〈0.05）.Compared with the parameters before PCI,for one-month parameters after PCI,GRS[（30.76±8.24）%vs（36.32 ±9.53）% ]and EF[（43.45±4.32）% vs（47.97±4.51）%]were significantly increased,GLS [（-12.35±2.10）% vs（-14.09±2.68）% ]was significantly decreased,GCS[（-11.74±3.66）% vs（-14.09 ±3.02）% ]was significantly decreased,[GAS（-22.15±4.16）% vs GAS（-24.71±4.59）%]was significantly decreased.（all P〈0.05）.Compared with the parameters before PCI,for three-month parameters after PCI,GRS[（30.76±824）% vs（37.74±9.68）%]and EF[（43.45±4.32）% vs（50.20±3.66）%]were significantly decreased,GLS[（-12.35±2.10）% vs（-14.59±2.92）%]was significantly decreased,GCS[（-11.74±3.66）% vs GCS（-15.21±3.25）%]was significantly decreased,GAS [（-22.15±4.16）% vs（-26.29±4.46）%],was significantly decreased,（all P〈0.05）.Conclusion：Mild and moderate reduced left ventricular function improve in patients with coronary disease after 1month and 3months post-PCI.