心肌做功测定在冠心病左心室功能评估中的应用价值

Application value of myocardial work assessment in evaluation of left ventricular function in coronary heart disease

目的探讨心肌做功测定在冠心病左心室功能评估中的应用价值。方法选择2020年5月至2021年9月于衢州市中医医院就诊的冠心病患者83例作为观察组,另择同期本院健康体检者50例作为对照组。冠心病患者分为节段性室壁运动异常亚组(25例)和无异常亚组(58例)。超声心动图测定左心室结构和功能。应用二维斑点追踪技术,测定整体纵向应变(GLS)、整体无用功(GWW)、整体做功效率(GWE)、整体做功指数(GWI)、整体有用功(GCW)。分析心肌做功参数诊断冠心病的价值及心肌做功参数与左心室射血分数(LVEF)、GLS的相关性。结果观察组患者LVEF、GWE、GWI、GCW低于对照组,GWW、GLS高于对照组,差异均有统计学意义(均P<0.05)。异常亚组患者LVEF、GWE、GWI、GCW低于无异常亚组,GWW、GLS高于无异常亚组,差异均有统计学意义(均P<0.05)。冠心病患者GWW与LVEF呈负相关(r=-0.606,P<0.05),GWE、GWI、GCW与LVEF均呈正相关(r=0.646、0.625、0.630,均P<0.05),GWW与GLS呈正相关(r=0.659,P<0.05),GWE、GWI、GCW与GLS呈负相关(r=-0.649、-0.671、-0.584,均P<0.05)。结论心肌做功测定有助于评估冠心病患者心肌功能状态。

Objective To investigate the application value of myocardial work technique in evaluation of left ventricular function in coronary heart disease(CHD). Methods A total of 83 CHD patients admitted to Quzhou Hospital of TCM from May 2020 to September 2021 were selected as observation group, and 50 people who underwent physical examination were selected as control group. Patients with CHD were divided into wall motion abnormality subgroup(abnormal subgroup, n=25) and non-abnormal subgroup(n=58). Echocardiography was performed to measure left ventricular structure and function. Two dimensional speckle tracking was used to measure global longitudinal strain(GLS), myocardial global wasted work(GWW), global work efficiency(GWE), global work index(GWI) and global constructive work(GCW). The diagnostic value of myocardial work indices in the diagnosis of CHD and the correlation between myocardial work indices and LVEF and GLS were analyzed. Results Left ventricular ejection fraction(LVEF), GWE, GWI and GCW were significantly lower, and GWW and GLS were significantly higher in the observation group than in the control group(all P<0.05). LVEF, GWE, GWI and GCW in abnormal subgroup were lower than those in no abnormal subgroup, while GWW and GLS were higher than those in no abnormal subgroup, with statistical significance(all P<0.05). GWW was negatively correlated with LVEF(r=-0.606, all P<0.05), GWE, GWI, GCW were positively correlated with LVEF(r=0.646, 0.625, 0.630, all P<0.05), GWW was positively correlated with GLS(r=0.659, P<0.05), GWE, GWI and GCW were negatively correlated with GLS(r=-0.649, -0.671, -0.584, all P<0.05) in CHD patients. Conclusion Myocardial work assessment may be helpful for evaluating myocardial function in patients with CHD.