| 延东娥,高赟,陈新云.二维斑点追踪分层应变技术评价冠状动脉狭窄对收缩早期左室心肌运动的影响[J].中国医学影像技术,2020,36(1): |
| 二维斑点追踪分层应变技术评价冠状动脉狭窄对收缩早期左室心肌运动的影响 |
| Evaluation of the effect of coronary artery stenosis on left ventricular myocardial movement in early systolic stage by two-dimensional layer-specific speckle tracking echocardiography |
| 投稿时间：2019-05-08 修订日期：2020-01-15 |
| DOI： |
| 中文关键词: 超声心动描记术，二维 斑点追踪成像，分层 预拉伸 冠状动脉 左室 |
| 英文关键词:Echocardiography, two-dimensional Speckle tracking, layer-specific Pre-stretch Coronary artery Left ventricular |
| 基金项目:无 |
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| 中文摘要: |
| 目的 应用斑点追踪分层应变技术分析冠状动脉狭窄对收缩早期左室心肌运动的影响及其意义。方法 179例研究对象均接受冠状动脉造影检查，将左室心肌按18节段法进行划分，按供血的冠状动脉狭窄程度将所有心肌节段分为4组：对照组（狭窄率=0），轻度组（狭窄率＜50％），中度组（狭窄率≥50％～＜75％）和重度组（狭窄率≥75％）。应用二维超声斑点追踪分层应变技术获得左室壁内、中、外层和全层心肌各18节段纵向预拉伸峰值应变（Longitudinal Pre-Stretch peak Strain, LPSS)和圆周预拉伸峰值应变（Circumferential Pre-Stretch peak Strain,CPSS）数据。结果 内、中、外层以及全层心肌LPSS和CPSS峰值出现于收缩早期，测值对照组为正值，轻度组最高（P均<0.05），中度组/重度组最低（P均<0.05）。结论 正常左室心肌在收缩早期会有微幅拉伸运动，冠状动脉轻度狭窄时收缩早期心肌拉伸运动会加强，之后随着冠脉病变加重而逐渐减弱、消失甚至可能出现被动拉伸；斑点追踪技术是研究左室心肌运动无创可行的手段。 |
| 英文摘要: |
| Objective To explore the effect of severity of coronary artery Stenosis on left ventricular wall motion in early systole using two-dimensional layer-specific speckle tracking echocardiography (STE). Methods A total of 179 participants underwent coronary angiography and two-dimensional layer-specific STE. Left ventricular wall was divided according to 18 segment model and then categorized into 4 groups on the basis of the degree of stenosis in coronary arteries: control group (no stenosis), mild group (<50% stenosis), moderate group(50%~<75% stenosis), severe group (≥75% stenosis).Global and regional longitudinal pre-stretch peak strain (LPSS) and global and regional circumferential pre-stretch peak strain (CPSS) of the three layers of left ventricular wall were obtained with two-dimensional layer-specific speckle tracking echocardiography (STE). Results All of maximum levels of LPSS and CPSS occurred in early systole, regardless of the whole left ventricular wall or each myocardial layer (i.e., inner layer, middle layer or outer layer).For either whole left ventricular wall or each myocardial layer, mild groups had the highest LPSS levels and CPSS levels (all p<0.05), moderate groups or/and severe groups had the lowest LPSS levels and CPSS levels (all p<0.05), and control groups had median LPSS levels and CPSS levels (all p<0.05). Conclusion The mild stenosis of coronary arteries could result in abnormally enhanced stretch of the left ventricular myocardium. However, the stretch ability would be weakened or disappeared even turn into passive status with increased stenosis of coronary arteries. Speckle tracking echocardiography is a non-invasive and feasible method to study left ventricular myocardial motion. |
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