三维斑点追踪技术联合SYNTAX评分评价复杂冠状动脉疾病

Three-dimensional speckle tracking imaging combined with SYNTAX score in evaluating complex coronary artery disease

目的观察三维斑点追踪(3D-STI)技术联合冠状动脉SYNTAX评分(SS)评价复杂冠状动脉疾病(CAD)患者左心室心肌功能的价值。方法根据SS将78例CAD患者分为低分亚组(SS<23,n=26)、中分亚组(23≤SS<33,n=25)及高分亚组(SS≥33,n=27),应用3D-STI技术获取左心室整体纵向、径向、圆周、三维应变(GLS、GRS、GCS、G3DS)及各节段纵向、径向、圆周、三维应变(LS、RS、CS、3DS),计算平均基底段、中间段和心尖段LS、RS、CS、3DS,并进行组间比较。结果①低分、中分、高分亚组GLS、GRS、GCS和G3DS均呈减小趋势(P均<0.05),基底段LS、3DS,中间段和心尖段LS、RS、CS和3DS均呈减小趋势(P均<0.05);②ROC曲线分析示GLS、GCS、GRS和G3DS对不同程度CAD有一定检测价值,以G3DS及GLS的AUC最大;③复杂CAD患者GLS、GRS、GCS和G3DS与冠状动脉SS均呈负相关(r=-0.548、-0.366、-0.411、-0.556,P均<0.05);④重复性检验示3D-STI参数在观察者内及观察者间测量均有良好一致性。结论3D-STI技术可在一定程度上反映复杂CAD患者冠状动脉病变程度,联合SS对于诊断CAD和指导治疗有一定意义。

Objective To explore the value of three-dimensional speckle tracking imaging(3D-STI)combined with coronary artery SYNTAX scores(SS)in evaluating the left ventricular function of patients with complex coronary artery disease(CAD).Methods Totally 78 patients with complex CAD were divided into low score subgroup(SS<23,n=26),medium score subgroup(23≤SS<33,n=25)and high score subgroup(SS≥33,n=27)according to SS.The global longitudinal strain(GLS),global circumferential strain(GCS),global radial strain(GRS),global three-dimensional strain(G3DS)and longitudinal strain(LS),radial strain(RS),circumferential strain(CS)as well as three-dimensional strain(3DS)of segments were obtained with 3D-STI.Then LS,RS,CS,3DS of basal segment,middle segment and apical segment were further calculated.The above indexes were compared among groups.Results①GLS,GRS,GCS and G3DS all decreased in turn among low score,medium score and high score subgroups(all P<0.05).LS,3DS of basal segment,LS,RS,CS and 3DS of middle segment and apical segment also decreased gradually(all P<0.05).②ROC curve showed that GLS,GRS,GCS and G3DS had a certain value in detecting degrees of complex CAD,and GLS and G3DS had larger AUC.③GLS,GRS,GCS and G3DS were negatively correlated with SS in the group of complex CAD(r=-0.548,-0.366,-0.411,-0.556,all P<0.05).④3D-STI had good interobserver and intraobserver consistency.Conclusion 3D-STI can reflect the complexity of coronary artery lesions,which has a certain guiding significance combined with SS in diagnosis and treatment of complex CAD.