CAJ | 학술논문

目的应用二维斑点追踪技术评价单支右冠脉病变患者左右心室的功能.方法对45例确诊为单支右冠脉病变的患者行超声心动图检查,30例有胸痛症状但冠脉造影未见明显狭窄的患者作为对照,记录左室长轴、心尖二腔及心尖四腔观的高帧二维图像,用二维应变软件获取左室18节段心肌纵向应变值、牛眼图及右室游离壁基底段、中间段和心尖段应变值.结果右冠脉狭窄但未发生心肌梗死的患者左室后壁基底段、中间段和心尖段,下壁基底段和中间段,后室间隔基底段、中间段应变值均减低(P均＜0.05)；左室整体应变值减低(P＜0.05)；右室游离壁中间段应变值减低(P＜0.05).右冠狭窄且发生心肌梗死的患者左室前室间隔基底段、中间段,前壁心尖段,后壁基底段、中间段和心尖段,下壁基底段、中间段,以及后室间隔基底段、中间段应变值均减低(P均＜0.05)；左室整体应变值减低(P＜0.05);右室游离壁中间段和心尖段应变值减低(P均＜0.05).结论二维斑点追踪技术可评估左右心室功能,且单支右冠病变患者左右心室均有多个节段应变值减低、功能受损,以左室下、后壁,左室整体及右室游离壁中间段为甚.
목적 응용이유반점추종기술평개단지우관맥병변환자좌우심실적공능.방법 대45례학진위단지우관맥병변적환자행초성심동도검사,30례유흉통증상단관맥조영미견명현협착적환자작위대조,기록좌실장축、심첨이강급심첨사강관적고정이유도상,용이유응변연건획취좌실18절단심기종향응변치、우안도급우실유리벽기저단、중간단화심첨단응변치.결과 우관맥협착단미발생심기경사적환자좌실후벽기저단、중간단화심첨단,하벽기저단화중간단,후실간격기저단、중간단응변치균감저(P균＜0.05)；좌실정체응변치감저(P＜0.05)；우실유리벽중간단응변치감저(P＜0.05).우관협착차발생심기경사적환자좌실전실간격기저단、중간단,전벽심첨단,후벽기저단、중간단화심첨단,하벽기저단、중간단,이급후실간격기저단、중간단응변치균감저(P균＜0.05)；좌실정체응변치감저(P＜0.05);우실유리벽중간단화심첨단응변치감저(P균＜0.05).결론 이유반점추종기술가평고좌우심실공능,차단지우관병변환자좌우심실균유다개절단응변치감저、공능수손,이좌실하、후벽,좌실정체급우실유리벽중간단위심.
Objective To evaluate the usefulness of speckle tracking imaging(STI) for assessment of left ventricular(LV) and right ventricular (RV) functions in patients with isolated disease of right coronary artery.Methods 45 cases were diagnosed as single right coronary lesions given echocardiography,30 cases had chest pain but coronary angiography had not seen the obvious narrow as a comparison.The twodimensional loop-cinec were obtained in apical 4-chamber view,apical 2-chamber view and long axis of LV view.Eighteen segments of LV longitudinal peak systolic strain,global peak systolic strain of each view and three segments of RV free wall were measured by two-dimensional strain software.Results In the patients who had right coronary lesions but did not happen myocardial infarction,the strain(S) values in the base,mid and apex segmental of LV post wall,the base and mid segmental of LV inferior wall and the base and mid segmental of LV septum were significantly lower( P ＜0.05).The S values in the mid segment of RV free wall was lower( P ＜0.05).In the patients who had right coronary lesions and myocardial infarction,the S values in the base,mid segmental of LV antsept,the apex segmental of LV anterior wall,the base,mid and apex segmental of LV post wall,the base and mid segmental of LV inferior wall and the base and mid segmental of LV septum were significantly lower( P ＜0.05).The S values in the mid and apex segments of RV free wall were lower ( P ＜0.05).And the LV global longitudinal strains were lower in the two groups (P ＜0.05).Conclusions STI is a new and useful technology for assessment ventricular functions in patients with isolated disease of right coronary artery,and there are multiple segments impaired.