定量组织速度成像与应变率成像在急诊心肌缺血中的应用价值

Value of Quantitative Tissue Velocity and Strain Rate Imaging in the Acute Myocardial Ischemia of Emegency

目的探讨定量组织速度成像(QTVI)及应变率成像(SRI)在急诊心肌缺血中的临床应用价值。方法应用QTVI及SRI对32例急诊心肌缺血病人和30例正常人节段纵向收缩期(S)、舒张早期(E)及收缩期(A)的峰值速度(VS、VE、VA)、峰值应变率(SRS、SRE、SRA)进行测定。结果 VS:心肌缺血组室壁的不同水平均较正常对照组显著性减低;VE:除前间隔的心尖水平外,室壁较正常对照组显著性减低;VA:前壁的不同水平及前间隔的心尖水平心肌缺血组较对照组显著性减低;SRS、SRE:心肌缺血组不同水平左室室壁较对照组显著性减低;SRA:前壁的不同水平及前间隔的基底水平心肌缺血组较对照组显著性减低(P<0.05或P<0.01)。结论 QTVI及SRI技术是临床简便、无创,是准确评价急诊心肌缺血的有效方法。

Objective To observe myocardial velocity and strain rate characteristics in patients with acute myocardial ischemia（ AMI） of emergency,and to evaluate the clinical value of quantitative tissue velocity imaging（ QTVI） and strain rate imaging（ SRI） in quantitative assessment of left ventricular（ LV） region infarction myocardial function. Methods Thirty-two patients with AMI of coronary heart disease（ CHD）,30 control subjects were enrolled in the study. Longitudinal peak velocity,strain rate of LV anterior wall（ AW） and anterior interventricular septum（ AS） during systole,early diastole and atrium contraction（ VS,VE,VA）,（ SRS,SRE,SRA） were measured at different levels（ basal,middle and apical）. QTVI and SRI data were compared with coronary angiography results. Results VS： different levels of LV infarction wall significantly decreased in CHD group. VE： all levels of LV infarction wall,except for apex levels of AS,were significantly lower than those in control group. VA： different levels of AW and apex level of AS in CHD group were significantly lower than those in control group. SRS and SRE： all levels of LV infarction wall in CHD group were significantly lower than those in control group. SRA： different levels of AW and base level of AS in CHD group were significantly lower than those in control group（P〈0. 05,P〈0. 01 respectively）. Conclusion QTVI and SRI are sensitive and feasible in evaluating functions of congestive heart failure of myocardial ischemia of emergency.