二维斑点追踪对冠状动脉狭窄患者左心室整体收缩功能与同步性的研究

Assessment of left ventricular systolic function and synchrony with two dimensional speckle tracking imaging in patients with coronary artery stenosis

目的探讨二维斑点追踪显像（2D-STI）评价冠状动脉不同程度狭窄患者左室整体收缩功能和同步性的临床应用价值。方法所有患者按冠状动脉造影冠脉狭窄程度分为三组，I组22例，狭窄率50％～75％，Ⅱ组18例，狭窄率≥76％，正常对照组40例，无明显狭窄。所有患者行2D-STI检查，运用Qlab8．1软件脱机分析获得左心室整体纵向、圆周、径向应变（GLS、GCS、GRS）等左心室收缩功能参数及16节段纵向应变达峰时间标准差（Tls-16-SD）、12节段径向、环向应变达峰时间标准差（Trs-12-SD、Tcs-12-SD）等左室同步性参数。结果与正常对照组比较，冠心病I组常规超声心动图无阳性发现，而2D-STI显示GLS明显降低（P〈0．05），Tls-16-SD明显延长（P〈0．05），与I组和对照组比较，Ⅱ组常规超声心动图及2D-STI均有明显阳性表现。结论与常规超声心动图相比，2D-STI可早期客观评价冠状动脉轻度狭窄患者的左室收缩功能与同步性。

Objective To assess the clinical value of two-dimensional speckle tracking imaging （2D-STI） in evaluating left ventricular global systolic function and synchrony in patients with differerent degrees of coronary artery stenosis. Methods All patients were divided into 3 groups according to angiocardiography., group I including 22 patients with 50%-75 % coronary artery stenosis, group II including 18 patients with ≥76% coronary artery stenosis, and group III inclu- ding 40 subjects with no coronary artery stenosis as control groups. All patients were performed by 2D-STI, Offline analy- sis was carried out in Qlab 8.1 to require the systolic function parameters GLS （global longitudinal strain）, GRS（global radial strain）, GCS（global circumferential strain） and synchrony parameters TIs-I6-SD （standard deviation of times to peak longitudinal strain of 16 LV segments）, Trs-12-SD（standard deviation of times to peak radial strain of 12 LV segments）, Tcs-12-SD（standard deviation o{ times to peak circumferential strain o{ 12 LV segments）. Results Compared with control group,conventional echocardiography had no positive manifestations in group I, while GLS was significantly decreased, TIs-16-SD was significantly prolonged performed by 2D-STI （ P d0.05）. Compared with group I and control group, conventional echocardiography and 2D-STI respectively had significantly positive manifestations in group II. Conclusion 2D-STI can early assess LV systolic function and synchrony in patients with mild degree of coronary artery stenosis.