摘要
目的：应用应变成像技术定量分析冠心病患者左室缺血、梗死心肌运动变化特点，探讨其评价左室局部心肌功能异常的价值。方法：冠心病心绞痛组11例、心肌梗死组21例，对照组20例。应用二维彩色组织多普勒速度模式记录左室侧壁、后间隔、下壁、前壁、后壁及前间隔的运动图像，获取应变曲线，分别测量缺血、梗死心肌和正常心肌的收缩期应变（εsys）、最大应变（εmax）、收缩后缩短应变（εpss）及其持续时间（Tpss），并计算εpss与εsys、εmax比值（εpss/εsys、εpss/εmax）。结果：缺血及梗死心肌较正常心肌εsys、εmax绝对值显著降低，εpss绝对值、εpss/εsys、εpss/εmax显著增大，Tpss显著延长（P<0.01）；梗死心肌较缺血心肌εsys、εmax绝对值降低更加明显，εpss/εsys、εpss/εmax增大和Tpss延长更加明显（P<0.05或P<0.01）。结论：应变成像可定量评价冠心病患者左室局部心肌功能异常；收缩后缩短是缺血、梗死心肌的常见并且重要的特征，εpss/εsys、εpss/εmax和Tpss有助于区分缺血与梗死心肌。
Abstract
Objective: To quantitatively analyze the characteristics of myocardial motion by strain imaging in ischemic and infarct myocardium in patients with coronary artery disease, in order to explore its clinical value for assessment of regional left ventricular dysfunction. Methods: Twenty-one patients with myocardial infarction, 11 patients with angina pectoris and 20 healthy subjects were studied. Septal, lateral, anterior, inferior, anteroseptal and posterior wall of the left ventricle were scanned respectively using color tissue Doppler imaging, and strain curves were derived. The systolic strain(εsys), the maximum strain(εmax), the postsystolic shortening strain(εpss) and its duration(Tpss) from ischemic, infarct and normal myocardium were measured. The ratios of εpss and εsys, εpss and εmax(εpss/εsys, εpss/εmax) were calculated. Results: Compared with normal myocardium, the absolute magnitude of εsys and εmax were significantly lower, the absolute magnitude of εpss, εpss/εsys, εpss/εmax were significantly larger and Tpss significantly longer in the ischemic and infarct myocardium(all with P<0.01). Compared with the ischemic myocardium, the absolute magnitude of εsys and εmax decreased significantly, εpss/εsys, εpss/εmax and Tpss increased significantly in the infarct one(P<0.01 or P<0.05). Conclusions: Strain imaging can be used to quantitatively analyze regional left ventricular dysfunction in patients with coronary artery disease; postsystolic shortening is a common and important feature of the ischemic and infarct myocardium, εpss/εsys, εpss/εmax and Tpss may aid in differentiating infarct from ischemic myocardium.
关键词
冠状动脉硬化 /
心脏病 /
心肌缺血 /
超声心动描记术 /
多普勒 /
彩色
Key words
Coronary arteriosclerosis /
Heart diseases /
Myocardial ischemia /
Echocardiography /
Doppler /
color
邱 琼;杨 莉.
应变成像对冠心病患者左室局部心肌功能的研究[J]. 中国临床医学影像杂志. 2008, 19(1): 15-17
QIU Qiong;YANG Li.
Investigation of regional left ventricular function by strain imaging in patients with coronary artery disease[J]. Journal of China Clinic Medical Imaging. 2008, 19(1): 15-17
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