定量组织速度成像评价冠状动脉内支架植入术对左室心肌局部功能的影响

Quantitative tissue velocity imaging in assessing regional myocardial function in acute myocardial infarction treated by coronary stenting.

目的 应用定量组织速度成像 (QTVI)技术评价急性心肌梗死 (AMI)病人支架术对左室心肌各节段舒缩功能的影响。方法 用QTVI技术获取 2 0例正常人和 2 4例急性前壁心肌梗死病人左室心尖 3个长轴切面6个室壁各节段心肌长轴方向的同步运动曲线 ,测量 12个节段心内膜下心肌的VS、VE和VA。结果 正常和缺血状态下 ,长轴方向主要的心肌运动速度从基底向心尖都明显减低。AMI支架术后 3d与术前比较 ,各部位的VS、VE都无显著差异 ;目测评分正常且冠脉造影回旋支有病变的患者 ,心尖四腔观基底段和中间段的VS显著降低。术后 3个月与术前比较 ,运动恢复节段的VS、VE都有明显升高 ,运动未恢复节段的VS无显著差异 ,而VE有升高趋势且差异显著。结论 QTVI技术能同步定量定位分析左室局部心肌功能 ,判断室壁运动较目测评分法更准确 ;冠脉内支架植入术能明显改善远期左室局部心肌功能 。

Objective The function of regional myocardium of patients with myocardial infarction(MI) treated by intra-coronary stenting was determined with quantitative tissue velocity imaging(QTVI).Methods Twenty healthy controls and 24 patients with acute anterior myocardial infarction underwent QTVI with high-frame rates. The myocardial tissue velocity imaging in the apical 4-chamber view and apical 2-chamber view and apical longitude view were digitized and stored. Off-line ventricular walls regional velocity profiles along long axis were obtained, and systolic peak velocities (Vs) and early and late diastolic peak velocities (V E and V A) of 12 regional segments were measured.Results Under normal and ischemic conditions, 6 ventricular walls showed significant basal-apical myocardial velocity in the long-axis reduction in V S and V E and V A were significantly reduced in the abnormal segments in patients with MI. Conclusion QTVI can be used to analyze regional myocardial motion in the long-axis quantitatively and synchronously;intra-coronary stenting can obviously improve regional myocardial function of left ventricle,especially the diastolic function.