| 赵志玉,陈金玲,周青,曹省,宋宏宁,胡波,郭瑞强.心肌分层应变评价冠心病患者不同程度狭窄冠状动脉供血节段心肌收缩功能[J].中国医学影像技术,2015,31(11):1666~1670 |
| 心肌分层应变评价冠心病患者不同程度狭窄冠状动脉供血节段心肌收缩功能 |
| Layer-specific strain in assessment of systolic function of segments supplied by coronary artery with varying degrees of stenosis in coronary heart disease patients |
| 投稿时间：2015-03-16 修订日期：2015-07-06 |
| DOI：10.13929/j.1003-3289.2015.11.016 |
| 中文关键词: 冠状动脉疾病 心室功能,左 超声心动描记术 |
| 英文关键词:Coronary disease Ventricular function, left Echocardiography |
| 基金项目:湖北省卫计委青年人才项目(WJ2015Q016)。 |
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| 中文摘要: |
| 目的 采用二维斑点追踪成像(2D-STI)分层应变技术评价冠心病患者左心室局部收缩功能。方法 临床疑诊冠心病患者50例,根据SCA结果,将患者分为冠心病组(重度狭窄亚组和轻度狭窄亚组)和对照组。获取各组节段心内膜下、中层、心外膜下心肌纵向应变(LSendo、LSmid、LSepi)及心肌圆周应变(CSendo、CSmid、CSepi),计算各节段心肌纵向应变跨壁梯度△LS和各节段心肌圆周应变跨壁梯度△CS,并进行统计学分析。结果 无论有无冠状动脉狭窄,其相应供血左心室心肌节段LSendo、LSmid、LSepi和CSendo、CSmid、CSepi均呈梯度递减,3组间△LS差异无统计学意义,重度狭窄亚组及轻度狭窄亚组△CS较对照组显著减小(P<0.05);与对照组比较,重度狭窄亚组LSendo、LSmid、LSepi及轻度狭窄亚组LSmid、LSepi均显著减低(P<0.05),但轻度狭窄亚组与重度狭窄亚组间各纵向分层应变参数差异无统计学意义(P均>0.05);与对照组比较,重度狭窄亚组CSendo、CSmid、CSepi均显著降低(P均<0.05),轻度狭窄组CSendo显著降低(P<0.05);重度狭窄亚组与轻度狭窄亚组间各圆周分层应变差异无统计学意义(P均>0.05)。结论 2D-STI 心肌分层应变技术可准确评价冠心病患者左心室各层心肌纵向及圆周应变,冠心病患者重度狭窄冠状动脉供血节段心肌全层收缩功能均不同程度受损,其中以心内膜下心肌受损最为严重。 |
| 英文摘要: |
| Objective To analyze layer-specific strain of left ventricular segments by two-dimensional speckle tracking imaging (2D-STI) in coronary heart disease (CHD) patients, and to evaluate the regional systolic function of left ventricle (LV). Methods Fifty patients were enrolled with suspected CHD. According to the results of selective coronary arteriography (SCA), all patients were divided into coronary heart group (severe stenosis subgroup and mild stenosis subgroup) and control group. All longitudinal strain and circumferential strain of the endo-myocardium, mid-myocardium and epi-myoccardium (LSendo, LSmid, LSepi, CSendo, CSmid and CSepi) were attained. The transmural gradient of LS (△LS) and transmural gradient of CS (△CS) were calculated. The statistical analysis was performed. Results With or without corresponding blood-supply coronary artery stenosis, LSendo, LSmid, LSepi, CSendo, CSmid and CSepi showed a gradient decrease. There was no significant difference in △LS among the three groups. Compared with control group, △CS of severe and mild stenosis subgroup decreased significantly (both P<0.05). Moreover, compared with control group, LSendo, LSmid, LSepi of severe stenosis subgroup and LSmid, LSepi of mild stenosis subgroup decreased significantly (all P<0.05), while there was no significant difference between mild and severe stenosis subgroup in the longitudinal of layer strain (all P>0.05). Compared with control group, CSendo, CSmid, CSepi of severe stenosis subgroup decreased significantly (all P<0.05), CSendo of mild subgroup decreased significantly (P<0.05). There was no significant difference of circumferential layer strain between mild stenosis and severe stenosis group (all P>0.05). Conclusion Layer-specific strain of 2D-STI can evaluate the longitudinal and circumferential strain in all left ventricular layers in patients with CHD accurately. Systolic dysfunction is happened through all layers in segments supplied by severe coronary artery stenosis in CHD patients, especially worst in the endocardial myocadium. |
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