CAJ | 학술논문

目的探讨超声斑点追踪二维应变检测冠心病左室心肌同步性的临床价值.方法采用二维应变对33例冠心病患者及30例正常人的冠状动脉(冠脉)供血区域进行检测,测量自QRS波起始至收缩期纵向应变达峰时间间期(Ts)及左室18节段的Ts标准差(Ts-SD).结果狭窄<75%冠脉供血节段共168个,狭窄≥75%冠脉供血节段共210个.①狭窄≥75%冠脉供血节段与正常对照组比较,绝大部分节段Ts明显延迟,Ts-SD明显升高;②狭窄≥75%冠脉供血节段与狭窄<75%冠脉供血节段相比,大部分节段Ts明显延迟,Ts-SD明显升高;③狭窄<75%冠脉供血节段与正常对照组比较,绝大部分节段Ts及Ts-SD差异无统计学意义;④以Ts-SD≥33.0 ms为左室收缩不同步,26例冠脉狭窄≥75%冠心病患者中22例(84.6%)收缩不同步,7例冠脉狭窄<75%冠心病患者中无收缩不同步.结论当冠脉出现严重狭窄,在二维超声心动图上未能观察到室壁运动异常时,二维应变已能准确检测出其心肌运动不同步现象.
목적 탐토초성반점추종이유응변검측관심병좌실심기동보성적림상개치.방법 채용이유응변대33례관심병환자급30례정상인적관상동맥(관맥)공혈구역진행검측,측량자QRS파기시지수축기종향응변체봉시간간기(Ts)급좌실18절단적Ts표준차(Ts-SD).결과 협착<75%관맥공혈절단공168개,협착≥75%관맥공혈절단공210개.①협착≥75%관맥공혈절단여정상대조조비교,절대부분절단Ts명현연지,Ts-SD명현승고;②협착≥75%관맥공혈절단여협착<75%관맥공혈절단상비,대부분절단Ts명현연지,Ts-SD명현승고;③협착<75%관맥공혈절단여정상대조조비교,절대부분절단Ts급Ts-SD차이무통계학의의;④이Ts-SD≥33.0 ms위좌실수축불동보,26례관맥협착≥75%관심병환자중22례(84.6%)수축불동보,7례관맥협착<75%관심병환자중무수축불동보.결론 당관맥출현엄중협착,재이유초성심동도상미능관찰도실벽운동이상시,이유응변이능준학검측출기심기운동불동보현상.
Objective To evaluate the dyssynchrony of left ventricle in patients with coronary artery disease(CAD) by two-dimensional strain echocardiography (2-DS). Methods The myocardium of left ventricle of 33 patients with CAD and 30 nomal controls were detected by 2-DS. The time from onset QRS complexes to peak systolic longitudinal strain(Ts) and the standard deviation of Ts of 18 left ventricular segments (Ts-SD)were measured. Results There were 168 segments whose flow was provided by coronary artery with stenosis≤75% ,210 segments whose flow was provided by coronary artery with stenosis 75 %. ①Ts was delayed significantly and Ts-SD was obviously higher in patients with stenosis≥75% when compared with the control group. ②Ts was delayed and Ts-SD was higher in patients with stenosis≥75% compared with those whose stenosis was ≤75%. ③There were no statistical differences in Ts and Ts-SD between the patients with stenosis ≤75% and the control group. ④When left ventricular systolic dyssynchrony was defined as Ts-SD≥33.0 ms, there were 22 patients with systolic dyssynchrony of all 26 patients whose coronary artery stenosis≥75%, there were no patient with systolic dyssynchrony of all 7 patients whose stenosis ≤75%. Conclusions Although there are no evident regional wall motion abnormalities by routine echocardiography,in patients with severe coronary artery stenosis,2-DS can detect exactly the dyssynchrony of left ventricle.