王春梅,庄晓晨,关丽娜,穆玉明.三维斑点追踪技术评价冠状动脉单支重度病变患者经皮冠状动脉介入术前后右心室功能变化[J].中国医学影像技术,2020,36(1):11~15
三维斑点追踪技术评价冠状动脉单支重度病变患者经皮冠状动脉介入术前后右心室功能变化
Assessment of right ventricular function with three-dimensional speckle tracking in severe single vessel coronary artery disease patients before and after percutaneous coronary intervention
投稿时间:2019-11-06  修订日期:2019-12-20
DOI:10.13929/j.issn.1003-3289.2020.01.003
中文关键词:  经皮冠状动脉介入治疗  心室功能,右  斑点追踪成像
英文关键词:percutaneous coronary intervention  ventricular function, right  speckle tracking imaging
基金项目:新疆维吾尔自治区自然科学基金联合基金(2016D01C266)。
作者单位E-mail
王春梅 新疆医科大学第一附属医院心脏超声诊断科, 新疆 乌鲁木齐 830011  
庄晓晨 新疆医科大学第一附属医院心脏超声诊断科, 新疆 乌鲁木齐 830011  
关丽娜 新疆医科大学第一附属医院心脏超声诊断科, 新疆 乌鲁木齐 830011  
穆玉明 新疆医科大学第一附属医院心脏超声诊断科, 新疆 乌鲁木齐 830011 mym1234@126.com 
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中文摘要:
      目的 以三维斑点追踪成像(3D-STI)技术评价冠状动脉单支重度病变患者PCI术前后右心室(RV)功能变化。方法 选取25例接受支架植入术的单支重度冠状动脉病变患者为病例组,42例无明显狭窄者为对照组。PCI术前及术后1、3个月采集二维及三维超声图像,测量并计算右心室常规参数及三维应变指标,分析三维图像获取右心室面积变化率(RVFAC-3D)、三尖瓣环收缩期位移(TAPSE-3D)、右心室收缩末期容积(RVESV)、右心室舒张末期容积(RVEDV)、右心室射血分数(RVEF-3D)、右心室每搏输出量(RVSV)及右心室游离壁(FW)和室间隔(Sep)纵向应变(RVLS)。结果 病例组术前右心室心肌功能指数(RVMPI)较对照组增大(P<0.05),TAPSE-3D、Sep-RVLS和FW-RVLS显著减小(P均<0.05),其他参数差异均无统计学意义(P均>0.05);病变血管为右冠状动脉(RCA)者FW-RVLS减小更明显(P<0.05),其他参数在不同病变血管间差异无统计学意义(P均>0.05)。病例组术后右心功能较术前改善明显(P均<0.05)。结论 冠状动脉单支重度病变引起RV功能受损,以RCA病变患者受损更著,FW-RVLS具有较好提示意义;PCI术后RV功能较术前有所改善。
英文摘要:
      Objective To evaluate changes of right ventricular (RV) function in severe single vessel coronary artery disease patients before and after percutaneous coronary intervention (PCI) using three-dimensional speckle tracking imaging (3D-STI). Methods Totally 25 patients with severe single vessel coronary artery disease but not myocardia infarction who underwent successful PCI were included in case group, while 42 patients without obvious coronary artery stenosis were selected as the controls(control group). Two-dimensional and three-dimensional (3D) ultrasonic images were collected before and 1 and 3 months after PCI. RV common parameters, right ventricular myocardial performance index (RVMPI), right ventricular fractional area change (RVFAC-3D), tricuspid annular plane systolic excursion (TAPSE-3D), right ventricular end-systolic volume (RVESV), right ventricular end-diastolic volume (RVEDV), right ventricular stroke volume (RVSV), right ventricular ejection fraction (RVEF-3D), right ventricular free wall longitudinal strain (FW-RVLS) and right ventricular septum longitudinal strain (Sep-RVLS) were measured. Results In case group, RVMPI significantly increased compared with control group, TAPSE-3D (P<0.05), Sep-RVLS and FW-RVLS significantly decreased before PCI (all P<0.05), while there was no significant difference of other parameters (all P>0.05). FW-RVLS was lower in patients with right coronary artery (RCA) stenosis than other conditions (P<0.05), and there was no significant difference of other parameters among different pathological vessels (all P>0.05). RV function were significantly improved 1 month and 3 months after PCI (both P<0.05)in case group. Conclusion The damage of RV function can be caused by severe single coronary artery lesion, especially in patients with RCA lesion. FW-RVLS3D-STI has good value for indicating damage of RV function, which might be improved after PCI.
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