| 陈立斌,许幼峰,曹涌,陈伟英,尹凤英.二维整体纵向应变检测冠心病患者冠状动脉重度狭窄[J].中国医学影像技术,2010,26(4):662~665 |
| 二维整体纵向应变检测冠心病患者冠状动脉重度狭窄 |
| Definition of severe coronary artery stenosis in patients with coronary artery disease with two-dimensional global longitudinal strain |
| 投稿时间：2009-09-21 修订日期：2009-12-29 |
| DOI： |
| 中文关键词: 超声心动描记术 应变 斑点追踪显像 冠状动脉狭窄 |
| 英文关键词:Echocardiography Strain Speckle tracking imaging Coronary stenosis |
| 基金项目: |
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| 中文摘要: |
| 目的 探讨利用左心室整体纵向应变(GLS)检测冠心病患者冠状动脉(CA)重度狭窄的价值。 方法 对42例经冠状动脉造影(CAG)证实的冠心病患者行二维应变超声心动图检查,分别获得其左心室GLS、室壁运动评分指数(WMSI)及左心室射血分数(LVEF),并以同期CAG结果作为金标准,分别计算GLS、WMSI、LVEF判断冠心病患者CA重度狭窄(狭窄率≥75%)的敏感度、特异度及ROC曲线下面积(AUC)。同期选取15名健康志愿者作为对照。 结果 ①判断≥1支CA重度狭窄的敏感度、特异度:以GLS －17.50%为界值,分别为77.51%、100%;以WMSI 1.00为界值,分别为70.01%、100%;LVEF以59.21%为界值,分别为57.51%、100%。②判断≥2支CA重度狭窄的敏感度、特异度:以GLS－11.05%为界值,分别为62.52%、80.81%;以WMSI 1.60为界值,分别为56.22%、65.31%;以LVEF 54.31%为界值,分别为56.21%、65.42%。③GLS与LVEF相关系数为0.78,WMIS与LVEF相关系数为－0.82;判断≥1支CA重度狭窄ROC曲线下面积(AUC):GLS为0.87,WMSI为0.80,LVEF为0.78;GLS的AUC大于LVEF(P＜0.01);判断≥2支CA重度狭窄GLS、WMIS、LVEF的AUC分别为0.76、0.64、0.64;GLS的AUC大于WMIS及LVEF(P均＜0.01)。 结论 GLS可用以判断冠心病患者CA重度狭窄,价值优于WMIS及LVEF。 |
| 英文摘要: |
| Objective To investigate the value of global longitudinal strain (GLS) in detecting severe coronary artery stenosis (SCAS) in patients with coronary artery disease. Methods Fourty-two patients with SCAS confirmed with coronary arteriongraphy (CAG) underwent two-dimensional strain echocardiography. GLS, wall motion score index (WMSI) and left ventricular ejection fraction (LVEF) were obtained. Taking CAG as gold standard, the sensitivity, specificity and areas under the ROC curve (AUC) of definition of SCAS with GLS, WMSI and LVEF were calculated, respectively. Fifteen healthy volunteers were recruited as control. Results ①Definition of one or more branches with severe stenosis: The sensitivity and specificity was 77.51% and 100% with GLS of －17.50% as a cutoff value, 70.01% and 100% with WMSI of 1.00, and 57.51% and 100% with LVEF of 59.21%. ②Definition of two or more than two branches with severe stenosis: The sensitivity and specificity was 62.52% and 80.81% with GLS of －11.05% as a cutoff value, 56.22% and 65.31% with WMSI of 1.60 and 56.21% and 65.42% with LVEF of 54.31%. ③The correlation coefficient was 0.78 between GLS and LVEF, and －0.82 between WMSI and LVEF. The AUC of detecting one or more branch with severe stenosis with GLS, WMIS and LVEF was 0.87, 0.80 and 0.78, respectively, and AUC of GLS was more than that of LVEF (P＜0.01). AUC of detecting two or more than two branches with severe stenosis with GLS, WMIS and LVEF was 0.76, 0.64 and 0.64, AUC of GLS was more than that of LVEF and WMSI (all P＜0.01). Conclusion GLS can be used in detecting SCAS, and the value of GLS is better than that of WMIS and LVEF. |
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