二维斑点追踪技术评价冠心病患者心肌功能的研究

Evaluation of myocardial function in patients with coronary heart disease by speckle tracking imaging

目的应用二维斑点追踪成像(speckle tracking imaging,STI)技术对常规方法显示室壁运动正常的冠心病患者进行定量分析,探讨STI技术用于诊断冠心病的临床应用价值。方法采集经冠状动脉造影证实的50例冠心病和40例对照组患者的心尖长轴、四腔和两腔观的二维灰阶动态图像,测量比较两组各节段纵向收缩期峰值应变(global longitudinal systolic peak strain,GLPS)及整体纵向平均应变(GLPS-Avg),应用受试者工作特征曲线(receiver operating characteristic curve,ROC曲线)评价GLPSAvg对筛选冠心病的敏感性和特异性。结果冠心病组各节段心肌的GLPS均明显低于对照组,差异性具统计学意义(P<0.05)。GLPS-Avg冠心病组(-15.79%±3.35%)绝对值低于正常组(-19.02%±2.78%)的绝对值,有统计学差异(P<0.05)。ROC曲线显示以GLPS-Avg-17.7%作为筛选冠心病的截断值,其诊断敏感性为77.5%,特异性为60.0%,AUC=0.777。结论 STI作为早期诊断冠心病的指标是可行的。

Objective To investigate the clinical value of speckle tracking imaging（ STI） in the diagnosis of coronary heart disease（ CHD） with normal ventricular wall motion. Methods According to the results of coronary angiography,50 patients with CHD and 40 age-matched subjects were enrolled. The twodimensional loop-cines were obtained in apical 4-chamber view,apical 2-chamber view and long axis view of left ventricle. Globe longitudinal systolic peak strain（ GLPS） and average globe longitudinal systolic peak strain（ GLPS-Avg） were measured and calculated. GLPS-Avg were applied to evaluate the diagnostic efficiency for CHD by receiver operating characteristic curve. Results The absolute value of GLPS_Avg in CHD group（-15. 79% ±3. 35%） was significantly decreased compared with that of the normal group（- 19. 02% ± 2. 78%）.The cutoff value of GLPS-Avg to diagnose CHD was- 17. 7%,with the sensitivity 77. 5% and specificity60. 0%.Conclusions GLPS-Avg with STI technique was helpful to diagnose CHD.