斑点追踪成像评价冠心病患者左心房时相功能

Speckle tracking imaging of left atrial phasic function in patients with coronary heart disease

目的评价冠心病患者左心房时相功能的变化。方法收集经临床确诊为冠心病患者74例,对照组为45例健康志愿者,根据左心室舒张功能减低程度将病例组分为左心室舒张功能正常组、左心室舒张功能轻度减低组、左心室舒张功能中/重度减低组。应用斑点追踪成像(speckle tracking imaging,STI)技术采集心尖全容积图像得出2组左心房整体的长轴方向心房收缩期应变(left atrial global longitudinal strain in late diastole,Sa)、舒张早期应变(left atrial global longitudinal strain in early diastole,Se)、总应变(total strain,Stot=Sa+Se),分析冠心病患者左心房应变指标的改变及左心室舒张功能不同分级冠心病患者左心房应变指标的改变。结果与正常对照组比较,病例组储存功能(Stot:23.04±4.53 vs 25.35±2.66)、通道功能(Se:12.46±2.69 vs 13.53±1.99)减低,轻度左心室舒张功能减低冠心病患者通道功能及存储功能减低,中/重度左心室舒张功能减低冠心病患者左心房时相功能减低,差异均有统计学意义(P<0.05)。结论冠心病患者左心房通道功能、存储功能减低,收缩功能可维持,随着左心室舒张功能减低严重,左心房通道功能及存储功能进行性减低,左心室舒张功能轻度减低冠心病患者左心房收缩功能可维持,左心室舒张功能中/重度减低冠心病患者左心房收缩功能亦减低。

Objective To assess left atrial(LA)phasic function in patients with coronary heart disease(CHD).Methods A total of 74 patients with CHD were assigned to case group,as compared with 45 volunteers were assigned to control group.Patients in case group were divided into three groups according to the degree of left ventricular diastolic function,including left ventricular diastolic function normal group,left ventricular diastolic function mild reduction group,left ventricular diastolic function moderate/severe reduction group.Speckle tracking imaging(STI)were applied to collect full volume image of the apex and to obtain entire longitudinal systole strain(Sa),strain in early diastolic(Se),and total strain(Stot=Sa+Se)for two groups of left atrial.We analyze variation of left atrial strain index and left atrial strain index variation of different levels in patients with CHD based on ventricle diastolic.Results Compared with the control group,LA reservoir function and LA channel function were reduced significantly(Se:12.46±2.69 vs 13.53±1.99;Stot:23.04±4.53 vs 25.35±2.66).Differences in reservoir function and channel function were statistically significant in left ventricular diastolic function mild reduction group,LA phasic function in left ventricular diastolic function moderate/severe reduction group was decreased significantly(P<0.05).Conclusion LA reservoir function and channel function were impaired in patients with CHD and deteriorated with the reduction of left ventricular diastolic function.LA contraction is preserved in normal and mild groups while impaired in moderate/severe groups.