定量组织多普勒超声成像对缺血性心肌病冠脉左主干狭窄的预测价值

Predictive value of the quantitative tissue Doppler imaging for severe stenosis of the left main coronary artery in ischemic cardiomyopathy

目的:探讨定量组织多普勒超声成像技术(TDI)对缺血性心肌病患者冠脉左主干狭窄>75%的预测价值。方法:回顾性分析纳入103例缺血性心肌病冠脉左主干狭窄>75%的患者(病例组)和健康人群42例(对照组),行TDI测量超声相关参数,ROC曲线分析相关参数对缺血性心肌病患者冠脉左主干重度狭窄的预测价值。结果:病例组LVEF低于对照组,差异有统计学意义(P<0.05);与对照组比较,病例组V-bl、V-ba、V-bas、V-bp减小,差异有统计学意义(P<0.05);V-bl、V-ba、V-bas和V-bp的ROC曲线下面积(AUC)分别约0.68、0.79、0.78、0.71,截点值分别约5.57、4.54、4.72、5.14,差异均有统计学意义(P<0.05)。结论:通过定量分析缺血性心肌病患者多超声参数,认为TDI对缺血性心肌病冠脉左主干重度狭窄具有预测价值,可作为临床诊断冠心病的辅助诊断方法。

Objective:To assess the predictive value of quantitative tissue Doppler imaging(TDI)in severe stenosis(>75%)of the left main coronary artery(LM)in patients with ischemic cardiomyopathy(ICM).Methods:Retrospective study was performed in 103 cases of ICM with severe stenosis(>75%)of LM(case group),and 42 healthy subjects(control group).Both the patients and healthy controls underwent measurement of related parameters by quantitative TDI.ROC curve was used to analyze the value of related parameters in predicting the severity of stenosis of LM.Results:LVEF as well as levels of Vs-bl,Vs-ba,Vs-bas and Vs-bp was significantly lower in case group than in control group(all P<0.05).The area of V-bl,V-ba,V-bas and V-bp under the curve of ROC was 0.68,0.79,0.78 and 0.71,and the cut-off value was about 5.57,4.54,4.72 and 5.14,respectively.The difference was significant(all P<0.05).Conclusion:Quantitative analysis of the ultrasonic parameters in ICM patients indicates that TID can be valuable in predicting the severity of stenosis of LM,which may serve as a supplement diagnosis for ICM in clinic.