| 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PCI术前后右室功能变化的临床研究[J].中国医学影像技术,2020,36(1): |
| 三维斑点追踪技术评价冠状动脉单支重度病变患者PCI术前后右室功能变化的临床研究 |
| Assessment of right ventricular function by three-dimensional speckle tracking in patients with severe single vessel coronary artery disease before and after PCI |
| 投稿时间：2019-11-06 修订日期：2020-01-03 |
| DOI： |
| 中文关键词: 超声 经皮冠状动脉介入治疗 右心室功能 |
| 英文关键词:Echocardiography Percutaneous coronary intervention Right ventricular function |
| 基金项目:新疆维吾尔自治区自然科学基金联合基金(2016D01C266) |
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| 中文摘要: |
| 目的 采用三维斑点追踪（3D-STI）技术评价冠状动脉单支重度病变患者行PCI术前后右心室（RV）的功能变化特点 方法 据冠脉造影检测结果选取单支重度冠脉病变并接受支架置入术者25例为病例组，42例造影未见明显狭窄者设为对照组。采集对照组、病例组PCI术前、术后1及3个月的二维及三维超声图像，测量并计算右室常规参数及三维应变指标，Echo PAC软件分析三维图像获取右室面积变化率(RVFAC-3D)、三尖瓣环收缩期位移（TAPSE-3D）、右室收缩末期容积（RVESV）、右室舒张末期容积（RVEDV）、右室射血分数（RVEF-3D)、右室每搏输出量（RVSV）及右室游离壁（FW）和室间隔（Sep）的纵向应变（RVLS）。结果 相比于对照组，PCI术前病例组的右室心肌功能指数（RVMPI）增大（P＜0.05），TAPSE-3D、Sep-RVLS和FW-RVLS显著减小（P＜0.05），其他参数无显著性差异（P＞0.05）；病变组中，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没有明显差异（P＞0.05）。与术前相比，病例组PCI术后1月、3月右心功能改善明显（P＜0.05）。结论 冠状动脉单支重度病变引起RV功能受损，RCA病变者受损更为明显， FW-RVLS具有较好的提示意义；PCI术后RV功能较术前有所改善。3D-STI对定量评价冠状动脉单支重度病变患者PCI术后的RV功能变化具有独特优势。 |
| 英文摘要: |
| Objective To evaluate the right ventricular (RV) function alterations in patients with severe single vessel coronary artery disease before and after percutaneous coronary intervention（PCI）using three-dimensional speckle tracking imaging (3D-STI). Methods 25 patients were selected as the case group according to the results of coronary angiography (CAG) and successfully underwent PCI, 42 patients without obvious stenosis were selected as the control group. Both two-dimensional and three-dimensional(3D) ultrasonographic images of these two groups were collected before and after 1 and 3 month after successful PCI. The RV common parameters, the right ventricular myocardial performance index (RVMPI), right ventricular fractional area change (RVFAC-3D), tricuspid annular plane systolic excursion(TAPSE-3D), right ventricular end-diastolic volume (RVEDV), right ventricular end-systolic volume (RVESV), 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) was measured. Results Compared with the control group，RVMPI were significantly increased while TAPSE-3D, Sep-RVLS and FW-RVLS were significantly decreased in case group before PCI (P＜0.05). In the case group, FW-RVLS was lower in subjects with the right coronary artery (RCA) stenosis than other conditions (P＜0.05）. RV function were significantly improved 1 month and 3 month after PCI (P＜0.05). Conclusion The damage of RV function can be caused in severe single coronary artery lesion and especially in patients with RCA lesion, and this deterioration in RV function can be reversed after PCI. Moreover, 3D-STI has unique advantages in quantitatively evaluating the changes of RV function in patients with severe single-vessel coronary artery disease after PCI. |
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