二维斑点追踪显像技术评价冠状动脉慢血流患者左心室收缩及舒张功能

doi:DOI:10.12117/jccmi.2019.04.010

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摘要目的：应用二维斑点追踪显像技术（2D-STI）评价冠状动脉慢血流（SCF）患者左心室整体及局部收缩及舒张功能。方法：40例SCF患者均行超声检查，应用常规超声心动图测量左心室收缩末期内径（LVDS）、左心室舒张末期内径（LVDD），根据Simpson公式原理计算左心室收缩末期容积（LVESV）、舒张末期容积（LVEDV）、射血分数（LVEF）。测量二尖瓣血流舒张早期峰值流速（E）和舒张晚期峰值流速（A），并计算E/A比值。应用2D-STI测量应变参数：收缩期左心室的纵向峰值应变（LS）并计算平均值作为左心室整体纵向收缩峰值应变（GLS）、达峰时间（TPSLS）；左心室各节段心肌的纵向、径向、圆周应变峰值（LSpeak、RSpeak、CSpeak）及达峰时间（TPSLS、TPSRS、TPSCS）；舒张早期纵向峰值应变率（SRe）、舒张晚期纵向峰值应变率（SRa）及应变显像舒张指数（SI-DI）。获得左心室整体及各节段应变曲线。另选冠状动脉造影正常的40例患者作为对照组，进行比较分析。结果：左心室整体纵向应变指标的比较：病例组患者心肌的GLS较对照组有不同程度降低，TPSLS延迟，差异有统计学意义（P<0.05）。病例组患者局部心肌应变指标的比较：SCF节段与非SCF节段相比，SCF节段的LSpeak、RSpeak、CSpeak减低，TPSLS、TPSRS、TPSCS延迟，差异均有统计学意义（P<0.05）。慢血流节段心肌SRe、SRa、SI-DI有不同程度降低，差异均有统计学意义（P<0.05）。结论：2D-STI可以评价SCF患者左心室整体及局部收缩及舒张功能。

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	赵春颖
	李玉宏

关键词 ：心室功能, 左, 冠状动脉疾病, 超声心动描记术

Abstract：Objective: To evaluate the left ventricular global and regional systolic and diastolic function in patients with slow coronary flow(SCF) by two-dimensional speckle tracking image(2D-STI). Methods: Forty patients with slow coronary flow underwent echocardiography, 40 persons with normal coronary angiography were selected as control group. The left ventricular end systolic diameter(LVDS), left ventricular end diastolic diameter(LVDD), left ventricular end systolic volume(LVESV), left ventricular end diastolic volume(LVEDV), left ventricular ejection fraction(LVEF) were measured by two-dimensional echocardiography and apical biplane Simpson’s method. The A and E peak flow velocity of mitral valve and E/A were obtained by pulsed-wave Doppler. The longitudinal peak strain(LSpeak), global longitudinal strain(GLS), TPSLS. Longitudinal, radial, circumferential strain peaks(LSpeak, RSpeak, CSpeak), and the time to peak strain (TPSLS, TPSRS, TPSCS), early diastolic peak strain rate(SRe)， late diastolic peak strain rate(SRa) and train imaging diastolic index(SI-DI) and the strain curve of global and each segment were obtained by 2D-STI. These data were compared between groups. Results: The GLS of left ventricular in SCF group was decreased in different degrees and TPSLS was delayed compared with control group, the difference was statistically significant(P<0.05). The LSpeak, RSpeak, CSpeak in SCF segments were decreased and TPSLS, TPSRS, TPSCS were delayed compared with non-SCF segments, the difference was statistically significant(P<0.05). SRe, SRa and SI-DI were decreased in different degrees in slow coronary flow segments, the difference was statistically significant(P<0.05). Conclusion: 2D-STI can assess left ventricular global and regional systolic and diastolic function in patients with SCF.

Key words： Ventricular function, left Coronary disease Echocardiography

收稿日期: 2018-04-20

PACS:	Ｒ543.3
	Ｒ540.45

基金资助:辽宁省自然科学基金（20170540381）。

通讯作者: 李玉宏，锦州医科大学附属第一医院超声医学科，121013。

作者简介: 赵春颖（1982-），女，吉林德惠人，主治医师。

引用本文:

赵春颖，李玉宏. 二维斑点追踪显像技术评价冠状动脉慢血流患者左心室收缩及舒张功能[J]. 中国临床医学影像杂志, 2019, 30(4): 267-270.
ZHAO Chun-ying, LI Yu-hong. Evaluation of left ventricular systolic and diastolic function in patients with slow coronary flow by two-dimensional speckle tracing technique. JOURNAL OF CHINA MEDICAL IMAGING, 2019, 30(4): 267-270.

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http://www.jccmi.com.cn/CN/DOI:10.12117/jccmi.2019.04.010 或 http://www.jccmi.com.cn/CN/Y2019/V30/I4/267

[1]Wang Y, Ma C, Zhang Y, et al. Assessment of left and right ventricular diastolic and systolic functions using two-dimensional speckle-tracking echocardiography in patients with coronary slow-flow phenomenon[J]. PLoS One, 2015, 10(2): e0117979. [2]杨娅，张小杉，李志安，等．冠状动脉慢血流现象的冠状动脉血流成像分析[J]. 中华超声影像学杂志，2011，20（3）：185-188. [3]刘金来. 冠状动脉慢血流的诊断与治疗进展[J]. 中华临床医师杂志：电子版，2009，3（7）：1077-1081. [4]祁明，李玉宏. 斑点追踪显像技术评价PCI对急性心肌梗死患者左心室局部收缩功能的影响[J]. 中国医学影像技术，2011，27（2）：308-312. [5]王秋霜，张慧，王禹，等. 超声二维斑点追踪技术评价心力衰竭患者二维整体应变[J]. 中国医学影像技术，2010，26（3）：500-503. [6]Gibson CM, Cannon CP, Daley WL, et al. TIMI frame count: a quantitative method of assessing coronary artery flow[J]. Circulation, 1996, 93(5): 879-881. [7]Sutherland GR, Di Salvo G, Claus P, et al. Strain and strain rate imaging: a new clinical approach to quantifying regional function[J]. J Am Soc Echocardiogr, 2004, 17(7): 788-802. [8]Meng K, Lv SZ, Zhu HG, et al. Use of tailored loading-dose clopidogrel in patients undergoing selected percutaneous coronary intervention based on adenosine diphosphate-mediated platelet aggregation[J]. Chin Med J(Engl), 2010, 123(24): 3578-3582. [9]Pekdemir H, Polat G, Cin VG, et al. Elevated plasma endothelin-1 levels in coronary sinus during rapid right atrial pacing in patients with slow coronary flow[J]. Int J Cardiol, 2004, 97(1): 35-41. [10]Cameli M, Ciccone MM, Maiello M, et al. Speckle tracking analysis: a new tool for left atrial function analysis in systemic hypertension: an overview[J]. J Cardiovasc Med(Hagerstown), 2016, 17(5): 339-343. [11]Yuda S, Muranaka A, Miura T. Clinical implications of left atrial function assessed by speckle tracking echocardiography[J]. J Echocardiogr, 2016, 14(3): 104-112. [12]Sanati H, Kiani R, Shakerian F, et al. Coronary Slow Flow Phenomenon Clinical Findings and Predictors[J]. Res Cardiovasc Med, 2016, 5(1): e30296. [13]Agarwal SK, Norby FL, Whitsel EA, et al. Cardiac autonomic dysfunction and incidence of atrial fibrillation: results from 20 years follow-up[J]. J Am Coll Cardiol, 2017, 69(3): 291-299. [14]Solomon SD, Glynn RJ, Greaves S, et al. Recovery of ventricular function after myocardial infarction in the reperfusion era: the healing and early afterload reducing therapy study[J]. Ann Intern Med, 2001, 134(6): 451-458. [15]马春梅，刘惠亮，罗建平，等. 斑点追踪技术与组织多普勒技术对不同年龄正常人左心室舒张功能的评价[J]. 中华医学超声杂志：电子版，2010，7（5）：819-823. [16]Spethmann S, Dreger H, Baldenhofer G, et al. Short-term effects of transcatheter aortic valve implantation on left atrial mechanics and left ventricular diastolic function[J]. J Am Soc Echocardiogr, 2013, 26(1): 64-71. [17]Morris DA, Parwani A, Huemer M, et al. Clinical significance of the assessment of the systolic and diastolic myocardial function of the left atrium in patients with paroxysmal atrial fibrillation and low CHADS(2) index treated with catheter ablation therapy[J]. Am J Cardiol, 2013, 111(7): 1002-1011. [18]Altekin RE, Kucuk M, Yanikoglu A, et al. Evaluation of the left ventricular regional function using two-dimensional speckle tracking echocardiography in patients with end-stage renal disease with preserved left ventricular ejection fraction[J]. Acta Cardiol, 2012, 67(6): 681-691.