STI评价冠心病并高血压左室正常构型病人左室心肌扭转运动的变化

SPECKLE TRACKING IMAGING ESSESSMENT OF CHANGES OF LEFT VENTRICULAR MYOCARDIAL TORSION IN CORONARY HEART DISEASE COMPLICATED HYPERTENSION PATIENTS WITH NORMAL VENTRICULAR GEOMETRY

目的应用二维超声斑点追踪成像(STI)技术评价冠心病并高血压左室正常构型病人左室心肌扭转运动的变化。方法冠心病并高血压左室正常构型病人90例,按照冠状动脉狭窄程度分为轻度病变组(A组)、中度病变组(B组)以及重度病变组(C组)3组。测量各组病人左室心内膜扭转角度峰值(P_(tw-endo))、心外膜扭转角度峰值(P_(tw-epi))、左室整体扭转角度峰值(P_(tw-bulk))和左室跨壁扭转角度梯度(P_(tw-mural))。以健康志愿者30例作为对照组(N组)。结果与N组比较,A组、B组、C组P_(tw-bulk)均减小(F=49.68,P<0.01);A组P_(tw-endo)和P_(tw-mural)明显减小(F=72.33、92.62,P<0.01);B组和C组P_(tw-endo)、P_(tw-epi)和P_(tw-mural)均减小(F=23.82~92.62,P<0.01)。随着冠状动脉狭窄程度增高,P_(tw-endo)、P_(tw-epi)和P_(tw-bulk)均呈逐渐减小趋势,A组、B组、C组比较差异有显著性(F=25.32~36.98,P<0.01);P_(tw-mural)亦呈逐渐减小的趋势(F=6.13,P<0.01),但B组和C组P_(tw-mural)比较差异无统计学意义(P>0.05)。结论 STI能够定量准确评价冠心病并高血压左室正常构型病人左室心肌扭转运动的变化。

Objective Two-dimensional speckle tracking imaging（STI）technique was adopted to evaluate left ventricular myocardial torsion（VMT）in coronary artery disease（CAD）complicated with essential hypertension patients with normal ventricular geometry. Methods Ninety patients with CAD and hypertension and normal ventricular geometry were selected and divided into three groups as A（mild lesion）,B（moderate lesion）and C（severe lesion）according to the degree of coronary artery stenosis.The left ventricular endocardial torsion（P（tw-endo））,epicardial torsion（P（tw-epi））,globe torsion（P（tw-bulk））and transmural torsion（P（tw-mural））were measured.Thirty healthy volunteers were enrolled and served as controls. Results Compared with the normal controls,the P（tw-bulk）in groups A,B and C were all decreased（F=49.68,P〈0.01）;in group A,P（tw-endo）and P（tw-mural）were decreased（F=72.33,92.62;P〈0.01）;in groups B and C,the P（tw-endo）,P（tw-epi）and P（tw-mural）were decreased（F=23.82-92.62,P〈0.01）.With the increase of stenosis of coronary artery,P（tw-endo）,P（tw-epi）and P（tw-bulk）showed gradually decreasing trend,the difference in this trend between groups A,B and C were significant（F=25.32-36.98,P〈0.01）;P（tw-mural）also showed a decreasing trend（F=6.13,P〈0.01）,but the difference in that between groups B and C was not statistically significant（P〈0.05）. Conclusion STI can be used to quantitatively and accurately evaluate left ventricular myocardial torsion in patients with coronary artery disease complicating essential hypertension with normal ventricular geometry.