摘要
目的:采用二维斑点追踪技术(2D-speckle tracking imaging,2D-STI)中心肌的收缩早期延迟时间指标对判断冠状动脉(冠脉)狭窄程度的价值.方法:对185例可疑冠脉狭窄患者在冠脉造影前48 h进行超声心动图检查,测量心肌的收缩早期延迟时间、纵向应变(longitudinal strain,LS)、径向应变(radial strain,RS)及圆周应变(circumferential strain,CS).根据冠脉造影结果分组:即冠脉无狭窄者为冠脉正常组(n=48),狭窄程度<50%者为轻度狭窄组(n=37),50%≤狭窄程度<70%者为中度狭窄组(n=55),70%≤狭窄程度<100%者为重度狭窄组(n=45).结果:与冠脉正常组比较,轻度狭窄组心肌的收缩早期延迟时间、纵向应变、径向应变及圆周应变无明显改变(P>0.05),中度狭窄组心肌的收缩早期延迟时间延长,纵向应变减低(P<0.05),重度狭窄组心肌的收缩早期延迟时间延长、纵向应变、径向应变及圆周应变均减低(P<0.01).ROC曲线显示,心肌的收缩早期延迟时间较纵向应变筛选冠脉中度、重度狭窄患者更佳.以收缩早期延迟时间为60.0 ms作为截断值时诊断价值最佳,敏感度为85.5%,特异度为74.1%,AUC=0.91.结论:中度以上的冠脉狭窄患者心肌的收缩早期时间明显延长,这一参数可准确识别不同程度冠状动脉狭窄患者.
Objectives: To evaluate the degree of coronary artery stenosis with duration of myocardial early systolic lengthening derived from 2D speckle tracking imaging (2D-STI) in patients with coronary artery disease (CAD). Methods: 185 patients with suspected CAD underwent 2D-STI before coronary CT angiography (CCTA) were included in this study. Duration of myocardial early systolic lengthening, LS, RS, and CS were measured by 2D-STI. According to the results of CCTA, the myocardial segment were divided into normal group (without coronary artery stenosis), mild stenosis group(coronary artery stenosis<50%), moderate stenosis group (50%≥coronary artery stenosis<70%) and severe stenosis group (70%≥coronary artery stenosis <100%). Results: Duration of myocardial early systolic lengthening, LS, RS and CS were similar between mild stenosis group and normal group (P﹥0.05). Duration of myocardial early systolic lengthening was increased, and LS was decreased in moderate stenosis group than in normal group (P<0.05). Duration of myocardial early systolic lengthening was increased, LS, RS and CS were significantly decreased in severe stenosis group than in normal group (P <0.01). The cutoff value of early systolic lengthening for diagnose severe stenosis was 60.0 ms (area under ROC curve [AUC]=0.91, P <0.01), with the sensitivity 85.5% and specificity 74.1%, respectively. Conclusions: Duration of myocardial early systolic lengthening is prolonged in patients with significant CAD (moderate and severe stenosis), and might be used a useful parameter to identify patients with significant CAD (moderate and severe stenosis).
作者
胡倩
刘佳
岳庆雄
HU Qian;LIU Jia;YUE Qingxiong(Department of Ultrasound,Dalian Municipal Central Hospital of Dalian Medical University,Dalian (116021),Lioaning,China)
出处
《中国循环杂志》
CSCD
北大核心
2019年第10期974-978,共5页
Chinese Circulation Journal
关键词
斑点追踪技术
收缩早期延迟时间
纵向应变
径向应变
圆周应变
冠心病
speckle tracking imaging
duration of myocardial early systolic lengthening
longitudinal strain
radial strain
circumferential strain
coronary artery disease