超声二维应变对冠状动脉介入治疗术后患者左室扭转的研究

Two-dimensional strain echocardiography in evaluating left ventricular twist in patients after percutaneous coronary intervention

目的应用超声二维应变观察单支和多支冠状动脉病变的心绞痛患者冠状动脉介入治疗(PCI)术后左室旋转和扭转运动变化情况。方法 70例心绞痛患者根据冠状动脉造影结果分单支病变组(n=33)和多支病变组(n=37),另选35例志愿者为对照组,分别记录PCI术前、术后3个月及对照组左室短轴二尖瓣环和心尖水平切面的二维灰阶图像,应用GE Echo PAC软件测量左室心尖部和心底部的旋转角度及旋转率,计算左室整体扭转角度及整体扭转率。结果单支病变组PCI术前整体扭转率与对照组比较差异有统计学意义(P<0.05),术后整体扭转率差异无统计学意义。单支病变组PCI术前及术后左室旋转度、旋转率、扭转度、扭转率及整体扭转度与对照组比较差异均无统计学意义。多支病变组PCI术前和术后整体扭转率与对照组比较差异有统计学意义(P<0.05)。多支病变组PCI术前及术后左室旋转度、旋转率、扭转度、扭转率及整体扭转度与对照组比较差异均无统计学意义。结论不同冠状动脉病变的心绞痛患者PCI术后左室整体扭转率改善情况有所不同,超声二维应变能够定量测量左室扭转运动。

Objective To explore the characteristics of left ventricular rotation and twist after percutaneous coronary intervention（PCI）in angina pectoris patients with single-vessel and multiple-vessel coronary artery disease by two-dimensional strain（2DS）echocardiography.Methods Totally 70 patients with angina pectoris were divided into single-vessel coronary artery disease group（n=33）and multiple-vessel coronary artery disease group（n=37）based on coronary angiography,and 35 healthy volunteers were enrolled as control group.The two-dimensional images from LV short-axis view at the levels of mitral annulus and apex were recorded before PCI and 3 months after PCI.Rotation angle and rotation rate of the left ventricular apex and base were measured with GE Echo PAC software.The left ventricular global torsion angle and torsion rate were calculated.Results Compared to control group,global torsion rate was lower in patients with single-vessel coronary artery disease before PCI（P〈0.05）,and it attained to normality 3 months after PCI,and it was lower in multiple-vessel coronary artery disease group before and after PCI（P〈0.05）.Compared to control group,there was no significantly difference of rotation,rotation rate,torsion,torsion rate and global torsion in single-vessel coronary artery disease group and multiple-vessel coronary artery disease group.Conclusion The improvements of global torsion rate are significantly different between angina pectoris patients with single-vessel and multiple vessel coronary artery disease after PCI.2DS can be used to precisely quantify left ventricular twist after PCI in patients with angina pectoris.