三维面积应变预判冠状动脉病变程度的价值

The value of 3-dimensional area strain in predicting coronary artery disease severity

目的探讨三维面积应变预判冠状动脉狭窄的价值。方法2018年1至10月在浙江省台州医院行常规超声心动图检查无室壁运动异常且行冠状动脉造影检查的患者100例,根据冠状动脉造影结果分为对照组(狭窄<50%)30例、低危组(1~2支主要血管狭窄≥70%)31例和高危组(3支主要血管狭窄≥70%或左冠状动脉主干狭窄≥50%)39例。利用三维应变成像技术测量左心室整体面积峰值应变(GAPS),比较组间GAPS差异。结果低危组、高危组、对照组GAPS分别为(-31.29±3.47)%、(-29.69±4.97)%、(-33.97±3.37)%,组间比较差异均有统计学意义(均P<0.05)。GAPS预判冠状动脉明显狭窄的最佳截断值为-31.5%,灵敏度为0.750,特异度为0.615,曲线下面积及95%可信区间为0.75(0.64~0.86)。结论对于无室壁运动异常的患者,GAPS可用于预判冠状动脉狭窄程度。

Objective To evaluate the value of three-dimensional area strain in predicting coronary artery disease(CAD)severity.Methods A total of 100 patients underwent coronary angiography and with normal ventricular wall movement on echocardiography were enrolled from January to October,2018 in Taizhou Hospital of Zhejiang Province.They were divided into control group with coronary artery stenosis<50%(30 cases),low-risk group with coronary stenosis≥70%in 1 to 2 vessels(31 cases)and high-risk group with coronary stenosis≥70%in 3 vessels or left main coronary artery stenosis≥50%(39 cases).Left ventricular global area peak strain(GAPS)was assessed using three-dimensional strain imaging and compared between groups.Results GAPS was(-31.29±3.47)%,(-29.69±4.97)%and(-33.97±3.37)%in low-risk group,high-risk group and control group,respectively.There was a significant difference between any two groups(all P<0.05).The optimal cutoff value for predicting critical coronary artery stenosis was-31.5%,with a sensitivity of 0.750 and a specificity of 0.615.The area under the curve and the 95%confidence interval were 0.75(0.64-0.86).Conclusion GAPS may be used to predict coronary stenosis severity in patients without abnormal ventricular wall motion.