三维斑点追踪技术评价NSTE-ACS患者左室局部心肌功能

Evaluation of left ventricular regional myocardial function in patients with NSTE-ACS by three-dimensional speckle tracking technology

目的:探讨三维斑点追踪技术(3D-STI)评价非ST段抬高型急性冠状动脉综合征(NSTE-ACS)患者左室局部心肌功能的临床应用价值。方法:入选103位NSTE-ACS患者,行3D-STI及冠脉造影(CAG)检查,利用3D-STI获取左室各节段纵向应变(LS)、圆周应变(CS)、径向应变(RS),根据冠脉狭窄部位及程度将心肌节段分为缺血节段组及非缺血节段组,比较两组应变。结果:与非缺血节段组相比,缺血节段组LS在左室各节段均降低(P<0.05),CS在前降支供血区基底段及中间段,回旋支供血区及右冠供血区降低(P<0.05),RS在左室各节段与非缺血节段组无统计学差异(P>0.05)。ROC曲线分析表明LS曲线下面积最大。结论:3D-STI可定量评价左室局部心肌功能,LS可敏感识别缺血心肌,有较高临床应用价值。

Objective: To investigate the clinical value of three-dimensional speckle tracking technology(3D-STI) in evaluating left ventricular regional myocardial function in patients with non-ST-segment elevation acute coronary syndrome(NSTE-ACS). Methods: One hundred and three patients with NSTE-ACS were enrolled in the study. 3D-STI and coronary angiography(CAG) were performed. The longitudinal strain (LS), circumferential strain (CS) and radial strain (RS) of the left ventricle were obtained by 3D-STI. According to the location and extent of coronary stenosis, the myocardial segment was divided into ischemic segment group and non-ischemic segment group, and the strains of the two groups were compared. Results: Compared with the non-ischemic segment group, the LS in the ischemic segment group decreased in all segments of the left ventricle (P<0.05). The CS in the basal segment and the middle segment of the left anterior descending artery blood-supply area, the left circumflex artery blood-supply area and the right coronary artery blood-supply area was decreased(P<0.05). There was no significant difference in RS between the ischemic segment group and the non-ischemic segment in all segments of the left ventricle(P>0.05). ROC curve analysis showed that the area under the LS curve was the largest. Conclusion: 3D-STI can quantitatively evaluate left ventricular regional myocardial function. LS may be used to identify ischemic myocardium and has high clinical value.