二维斑点追踪成像技术评价曲美他嗪治疗冠状动脉粥样硬化性心脏病伴心力衰竭左室局部收缩功能

Analysis on left ventricular contract function in patients with coronary heart disease and heart failure by two-dimensional speckle tracking imaging

目的应用二维斑点追踪成像技术评价曲美他嗪治疗冠状动脉粥样硬化性心脏病(以下简称冠心病)合并心力衰竭后左室局部收缩功能改变。方法选取冠心病患者48例(左室射血分数均<50%),随机分为治疗组24例和对照组24例,两组均给予冠心病常规治疗,治疗组加用标准剂量的曲美他嗪治疗6个月。应用二维斑点追踪成像技术测量并比较两组治疗前后左室前间隔和前壁的基底段、中间段及心尖段的纵向、径向及圆周应变收缩期峰值。结果治疗组和对照组治疗后各节段纵向、径向及圆周应变收缩期峰值均呈不同程度升高,与治疗前比较,差异均有统计学意义(均P<0.05)。治疗组治疗后纵向、径向及圆周应变收缩期峰值均较对照组治疗后明显提高,差异均有统计学意义(均P<0.05)。结论应用二维斑点追踪成像技术可对左室射血分数下降的冠心病患者接受曲美他嗪治疗后的左室局部收缩功能进行评估,具有一定的临床价值。

Objective To analyze the left ventricular（LV）contract function in patients with coronary heart disease（CHD）and heart failure by two-dimensional speckle tracking imaging. Methods Forty-eight patients of coronary heart disease with heart failure（EF〈50%） were enrolled and divided into treatment group（24 cases） and control group（24 cases） randomly.All patients received conventional therapy for coronary heart disease,extral treatment of trimetazidine for 6 months with standard daily dose in treatment group.The peak systolic strain of left ventricular anterior septum,the basal segment,middle segment,and apical segment of the anterior wall,in longitudinal,radial and circumferential section were analyzed before and after treatment by two-dimensional speckle tracking imaging. Results The peak systolic strain of all segments studied in longitudinal,radial and circumferential section significantly increased after treatment,compared to those before therapy for both groups（P〈0.05）,and the systolic strain of the treatment group significantly higher than that of the control group（P〈0.05）. Conclusion Two-dimensional speckle tracking imaging has potential clinical value to evaluate left ventricular regional systolic function for patients with coronary heart disease and left ventricular contract function failure treated with trimetazidine.