二维斑点追踪技术评价冠状动脉三支病变患者左心房功能

Two-dimensional speckle tracking echocardiography in evaluating left atrial function in patients with triple-vessel coronary artery disease

目的:应用二维斑点追踪技术(2D-STE)评价冠状动脉三支病变患者的左心房功能。方法:选取我院诊断为冠状动脉三支病变患者60例,选取30例健康志愿者纳入A组。根据冠状动脉造影结果分为两组,B组31例,三支冠脉狭窄率均为50%~<75%,C组29例,三支冠脉狭窄率均≥75%。通过实时三维超声(RT-3DE)测量左心房收缩期末最大容积(LAVmax)、收缩前容积(LAVp)、舒张期末最小容积(LAVmin)并通过计算获得左心房被动射血分数(LAPEF)、主动射血分数(LAAEF)及最大容积指数(LAVImax)。2D-STE测量舒张早期、舒张晚期及收缩期左心房整体纵向峰值应变率(LASRe,LASRa,LASRs)。利用Pearson线性相关分析B、C组2D-STE参数与LAVImax、LAPEF、LAAEF之间的相关性。结果:与A组相比,B组的LAPEF、LASRs、LASRe减低,而LAVImax、LAVmax、LAVmin、LAVp、LAAEF、LASRa升高(P均<0.05)。与A组和B组相比,C组LAVImax、LAVmax、LAVmin、LAVp升高,而LAAEF、LAPEF、LASRs、LASRe、LASRa均减低(P均<0.05)。LASRs与LAVImax呈正相关(r=0.658,P<0.01;r=0.684,P<0.01);LASRe与LAPEF呈负相关(r=-0.744,P<0.01;r=-0.795,P<0.01);LASRa与LAAEF呈负相关(r=-0.696,P<0.01;r=-0.70,P<0.01)。结论:2D-STE可以有效评价冠状动脉病变患者的左心房功能。

Objective:To assess left atrial function in patients with triple-vessel coronary artery disease by two-dimensional speckle tracking echocardiography(2 D-STE).Methods:Thirty healthy people were selected as group A.Sixty patients with triple-vessel coronary artery disease were enrolled,who were categorized into group B(n=31,all triple-vessel coronary artery stenosis 50%~<75%)and group C(n=29,all triple-vessel coronary artery stenosis≥75%)according to the coronary angiography findings.We measured LA volumes(max,min and pre-atrial contraction volume)using real-time three-dimensional e-chocardiography(RT-3 DE),then calculated LA passive and active ejection fraction(LAPEF,LAAEF),left atrial maximum volume index(LAVImax).The global peak longitudinal systolic strain(LASRs),early diastolic strain(LASRe)and late diastolic strain(LAS-Ra)rates of the LA were obtained by 2 D-STE.The correlation between the parameters of 2 D-STE and LAVImax,LAPEF,LAAEF in group B and C were analyzed by the Pearson liner correlation analysis.Results:In group B,LAVImax,LAVmax,LAVmin,LAVp,LAAEF and LASRa were significantly increased,while LAPEF,LASRs and LASRe were significantly decreased compared with the corresponding values in group A(all P<0.05).In group C,LAVImax,LAVmax,LAVmin and LAVp were significantly increased,while LAAEF,LAPEF,LASRs,LASRe,LASRa were significantly decreased compared with group A and group B.In addition,the correlation analysis in group B and C also showed a negative correlation between LASRe and LAPEF(r=-0.744,P<0.01;r=-0.795,P<0.01),a negative correlation between LASRa and LAAEF(r=-0.696,P<0.01;r=-0.70,P<0.01),and a positive correlation between LASRs and LAVImax(r=0.658,P<0.01;r=0.684,P<0.01).Conclusion:2 D-STE can evaluate the left atrial function in patients with triple-vessel coronary artery disease.