3D-STI下左心房功能参数与冠状动脉病变严重程度的相关性

Correlation between left atrial function parameters in 3D-STI and the severity of coronary artery lesions

目的采用三维斑点追踪成像(3D-STI)技术检测左心房功能参数,分析其与冠状动脉病变严重程度的相关性。方法选取CHD患者196例,根据冠状动脉病变程度(Gensini评分)分为轻度组68例和中重度组128例,另选取同期体检健康者42例为对照组。比较各组超声参数包括左心房前后径(LAD)、左室射血分数(LVEF)、二尖瓣口舒张早期峰值血流速度与瓣环室间隔侧舒张早期心肌峰值运动速度比值(E/e′)。采用3D-STI技术获取各组左心房最小容积指数(LAVI_(min))、左心房最大容积指数(LAVI_(max))、左心房主动收缩前容积指数(LAVI_(pre)),以及左心房心肌整体纵向应变(GLS)、环向应变(GCS)和径向应变(GRS)。结果与对照组比较,轻度组LAD、E/e′增大,GLS、GCS降低,中重度组LAD、E/e′增大,LVEF、GLS、GCS、GRS降低;与轻度组比较,中重度组LVEF、GLS、GCS和GRS降低,LAD、E/e′增大(P<0.05)。与对照组和轻度组比较,中重度组LAVI_(min)、LAVI_(max)和LAVI_(pre)增大(P<0.05)。CHD患者Gensini评分与LAVI_(min)、LAVI_(pre)呈正相关,与GLS、GCS和GRS呈负相关(P<0.05)。结论使用3D-STI技术检测左心房功能参数,有助于评估CHD患者冠状动脉病变程度。

Aim To analyze the correlation between left atrial function parameters in three-dimensional speckle tracking imaging(3D-STI)and the severity of coronary artery lesions.Methods A total of 196 patients with CHD were enrolled.According to the severity of coronary artery lesions(Gensini score),they were divided into mild group(68 cases)and moderate-severe group(128 cases).A total of 42 healthy controls during the same period were enrolled as control group.The ultrasound parameters in different groups including left atrial anteroposterior diameter(LAD),left ventricular ejection fraction(LVEF)and early diastolic transmittal velocity to early mitral anulus diastolic velocity ratio(E/e′)were compared.The_(min)imum left atrial volume index(LAVI_(min)),_(max)imum left atrial volume index(LAVI_(max)),left atrial active_(pre)-systolic volume index(LAVI_(pre)),global longitudinal strain(GLS),global circumferential strain(GCS)and global radial strain(GRS)were obtained by 3D-STI.Results Compared with the control group,the mild group had an increase in LAD and E/e′,while the GLS and GCS decreased.The moderate to severe group had an increase in LAD and E/e′,while LVEF,GLS,GCS,and GRS decreased;Compared with the mild group,the LVEF,GLS,GCS,and GRS in the moderate to severe group decreased,while LAD and E/e′increased(P<0.05).Compared with control group and mild group,LAVI_(min),LAVI_(max)and LAVI_(pre)were increased in moderate-severe group(P<0.05).Gensini score was positively correlated with LAVI_(min)and LAVI_(pre)but negatively correlated with GLS,GCS and GRS(P<0.05).Conclusion Monitoring left atrial function parameters by 3D-STI is beneficial to evaluate the severity of coronary artery lesions in CHD patients.