应用三维斑点追踪成像技术评价冠心病患者左室整体收缩功能

Three-dimensional Speckle Tracking Imaging Assessment of Left Ventricular Function in Patient with Coronary Heart Disease

目的应用三维斑点追踪成像技术(3DE-STI)评价冠状动脉不同狭窄程度患者的左室整体收缩功能。方法随机选取2016年8月—2017年8月经常规二维超声心动图(2DE)检查未发现节段性室壁运动异常的冠心病患者34例,根据冠脉造影结果按Gensini积分评分标准将冠心病组分为冠脉病变较轻A组(Gensini积分≤50分)及冠脉病变较重B组(Gensini积分>50分),健康志愿者31名作为对照组(C组)。所有纳入着均采用3DE-STI测量左室整体纵向应变(GLS)、径向应变(GRS)、圆周应变(GCS)、面积应变(GAS),采用Simpson法计算左室射血分数(LVEF),比较各组间三维斑点整体应变的差异性,并分析三维斑点整体应变与LVEF的相关性。结果与C组的整体纵向(16.78±1.48)、径向(40.72±5.10)、圆周(18.25±2.23)、面积(25.69±2.44)应变值比较,A组的整体纵向应变(12.39±3.08)及B组的整体纵向(10.97±3.58)、径向(33.56±7.20)、圆周(15.00±2.78)、面积(22.66±4.64)应变值降低,差异有统计学意义(P<0.05)。纳入者左心室整体纵向、径向、圆周、面积应变值与左室射血分数具有相关性,相关系数分别为0.72、0.53、0.45、0.50,差异有统计学意义(P<0.05)。结论3DE-STI较2DE能更早发现心肌功能的改变,左室整体应变值的大小能在一定程度上反映不同冠脉病变程度患者的左室整体收缩功能。

Objective Three-dimensional speckle tracking imaging(3DE-STI)was used to evaluate left ventricular global systolic function in patients with different degrees of coronary artery stenosis.Methods Rancolm select from August 2016 to August 2017,34 patients with coronary heart disease who had no abnormal segmental wall motion abnormalities were examined by conventional two-dimensional echocardiography(2DE).According to the results of coronary angiography,the coronary heart disease group was selected according to the Gensini score.The coronary artery lesions were lighter in group A(Gensini score≤50 points)and coronary artery lesions in group B(Gensini score>50 points),and 31 healthy volunteers served as control group(group C).Left ventricular total longitudinal strain(GLS),radial strain(GRS),circumferential strain(GCS),and area strain(GAS)were measured by 3DE-STI,and left ventricular ejection fraction(LVEF)was calculated by Simpson method.The differences in the overall strain of the three-dimensional spots between the groups were compared,and the correlation between the overall strain of the three-dimensional spots and LVEF was analyzed.Results Compared with the overall longitudinal(16.78±1.48),radial(40.72±5.10),circumferential(18.25±2.23),and area(25.69±2.44)strain values of group C,the overall longitudinal strain of group A(12.39±3.08)And the overall longitudinal(10.97±3.58),radial(33.56±7.20),circumferential(15.00±2.78),and area(22.66±4.64)strain values of group B decreased,the difference was statistically significant(P<0.05).The overall longitudinal,radial,circumferential,and area strain values of the left ventricle were correlated with the left ventricular ejection fraction.The correlation coefficients were 0.72,0.53,0.45,and 0.50(P<0.05).Conclusion 3D-STI can show earlier in the change of cardiac function than conventional echocardiography,the changes of the global strain can reflect the left ventricle systolic function in CHD patients.