应用二尖瓣环位移评价冠心病患者左心功能

Evaluation of left ventricular function in patients with coronary heart disease by mitral annulus displacement

目的应用二维斑点追踪技术(2D-STI)测量二尖瓣环位移(MAD)评价冠心病患者左心功能。方法 20例冠心病患者作为冠心病组, 25例健康者作为对照组。测量两组二尖瓣环左右两个点的最大位移(TMAD1、TMAD2)、瓣环中点处最大位移(TMADmid)、TMADmid与左室舒张末期长径的百分比(TMADmid%)。对比两组MAD各参数的差异,分析冠心病组MAD与左心室射血分数(LVEF)的相关性。结果冠心病组LVEF水平为(43.35±3.23)%,低于对照组的(67.35±3.84)%,差异有统计学意义(P<0.05)。冠心病组TMAD1、TMAD2、TMADmid、TMADmid%水平分别为(8.59±0.88)mm、(9.38±1.07)mm、(9.03±0.89)mm、(10.33±0.98)%,均低于对照组的(12.35±2.21)mm、(14.26±3.02)mm、(13.75±2.56)mm、(15.27±3.21)%,差异均有统计学意义(P<0.05)。冠心病组MAD各参数(TMAD1、TMAD2、TMADmid、TMADmid%)与LVEF呈正相关(r=0.83、0.85、0.87、0.88, P<0.05)。以TMADmid%与LVEF的相关性最好。TMADmid%的曲线下面积(AUC)最高,为0.887。以TMADmid%预测冠心病,当截断值为10.8%时,敏感度为80%,特异度为80%。结论运用二维斑点追踪技术测量MAD可以准确、快捷地评估冠心病患者左室收缩功能。

Objective To evaluate left ventricular function in patients with coronary heart disease by mitral annulus displacement(MAD) measured with two-dimensional speckle tracking technique(2 D-STI).Methods There were 20 coronary heart disease patients as coronary heart disease group, and 25 healthy people as control group. Measurement were made on maximum displacement(TMAD1, TMAD2) at the two points on the left and right mitral annulus, the maximum displacement at the midpoint of the annulus(TMADmid), percentage of TMADmid% of the annulus and left ventricular end-diastolic long-term diameter(TMADmid%). The differences of MAD parameters between the two groups were compared and the correlation between MAD and left ventricular ejection fraction(LVEF) in coronary heart disease group was analyzed. Results Coronary heart disease group had lower LVEF as(43.35±3.23)% than(67.35±3.84)% in the control group, and the difference was statistically significant(P<0.05). Coronary heart disease group had lower TMAD1, TMAD2, TMADmid and TMADmid%level respectively as(8.59±0.88) mm,(9.38±1.07) mm,(9.03±0.89) mm and(10.33±0.98)% than(12.35±2.21) mm,(14.26±3.02) mm,(13.75±2.56) mm and(15.27±3.21)% in the control group, and their difference was statistically significant(P<0.05). The MAD parameters(TMAD1, TMAD2, TMADmid, TMADmid%) in coronary heart disease group were positively correlated with LVEF(r=0.83, 0.85, 0.87, 0.88, P<0.05), and the correlation between TMADmid% and LVEF was the best. The area under curve(AUC) of TMADmid% was the highest as 0.887. Predicting coronary heart disease with TMADmid%, when the truncation value was 10.8%,the sensitivity was 80% and specificity was 80%. Conclusion Two-dimensional speckle tracking technique measurement of MAD can accurately and quickly evaluate left ventricular systolic function in patients with coronary heart disease.