李阳,马春燕,刘爽,王永槐,关正宇,李烨,杨军.二维斑点追踪技术评价急性心肌梗死患者经皮冠状动脉介入治疗后冠状动脉侧支循环对左心室功能的影响[J].中国医学影像技术,2015,31(11):1653~1656
二维斑点追踪技术评价急性心肌梗死患者经皮冠状动脉介入治疗后冠状动脉侧支循环对左心室功能的影响
Two-dimensional speckle tracking echocardiographic evaluation of effect of coronary artery collateral circulation on left ventricular function in patients with acute myocardial infarction after percutaneous coronary intervention
投稿时间:2015-04-28  修订日期:2015-09-23
DOI:10.13929/j.1003-3289.2015.11.013
中文关键词:  冠状血管  侧支循环  心肌梗死  心室功能,左  斑点追踪成像  超声心动描记术
英文关键词:Coronary vessels  Collateral circulation  Myocardial infarction  Ventricular function, left  Speckle tracking imaging  Echocardiography
基金项目:沈阳市科学计划项目(F13-221-9-60)。
作者单位E-mail
李阳 中国医科大学附属第一医院心血管超声科, 辽宁 沈阳 110001  
马春燕 中国医科大学附属第一医院心血管超声科, 辽宁 沈阳 110001 mcy_echo@163.com 
刘爽 中国医科大学附属第一医院心血管超声科, 辽宁 沈阳 110001  
王永槐 中国医科大学附属第一医院心血管超声科, 辽宁 沈阳 110001  
关正宇 中国医科大学附属第一医院心血管超声科, 辽宁 沈阳 110001  
李烨 中国医科大学附属第一医院心血管内科, 辽宁 沈阳 110001  
杨军 中国医科大学附属第一医院心血管超声科, 辽宁 沈阳 110001  
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中文摘要:
      目的 采用二维斑点追踪成像(STE)技术评价急性心肌梗死(AMI)患者经皮冠状动脉介入治疗(PCI)后冠状动脉侧支循环(CCC)对左心室功能的影响。方法 选择接受急诊PCI的AMI患者51例,根据冠状动脉造影结果将患者分为有侧支循环组(CCC组)和无侧支循环组(N-CCC组)。再根据冠状动脉闭塞情况及室壁运动评分将患者左心室18节段心肌分为正常心肌组、缺血心肌组和梗死心肌组。患者分别在PCI术后72 h及1个月接受超声检查,检测并比较左心室心肌整体收缩、舒张功能及心肌纵向应变(LS)和应变率(LSR)。结果 与术后72 h比较,1个月时CCC组和N-CCC组缺血及梗死心肌的LS均增大(P<0.01)。术后72 h,CCC组缺血心肌LSR-s大于N-CCC组(P<0.05)。术后1个月,CCC组缺血及梗死心肌LS均大于N-CCC组(P<0.05),且恶性心律失常发生率低于N-CCC组(P<0.05)。结论 CCC可显著改善AMI患者PCI术后72 h缺血心肌和术后1个月缺血、梗死心肌的收缩功能及左心室整体舒张功能。
英文摘要:
      Objective To evaluate the effect of coronary artery collateral circulation (CCC) on left ventricular function in patients with acute myocardial infarction (AMI) after percutaneous coronary intervention (PCI) with two-dimensional speckle tracking echocardiography (STE). Methods Totally 51 AMI patients were performed PCI, who were divided into CCC group and N-CCC group based on the coronary angiography. According to the results of coronary artery occlusion and the wall motion score, the 18 segments myocardium of left ventricle were divided into 3 subgroups: Normal myocardium, ischemic myocardium and infracted myocardium. Echocardiography was performed in 72 h and 1 month after PCI. The longitudinal strain (LS) and strain rate (LSR) were measured to assess the LV global systolic and diastolic functions. Results LS in ischemic and infracted myocardium of all the patients 1 month after PCI increased compared with that in 72 h (P<0.01). LSR-s of ischemic myocardium in CCC group was higher than that in N-CCC group 72 h after PCI (P<0.05). LS in both ischemic and infracted myocardium in CCC group was higher than those in N-CCC group 1 month after PCI (P<0.05). In addition, the incidence of malignant arrhythmia decreased in CCC group (P<0.05). Conclusion CCC can significantly improve the systolic function of ischemic myocardium 72 h after PCI. The systolic function of ischemic and infracted myocardium and the left ventricular global diastolic function are also improved 1 month after PCI.
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