CAJ | 학술논문

目的应用应变率成像(SRI)技术评价冠状动脉搭桥(CABG)对冠心病患者左心房功能的影响.方法分别于CABG术前、术后1周、1月和3月应用SRI技术对23例冠心病患者左心房功能进行评价.结果与术前比较,术后I周左心房收缩期前容积(LAVp)、最大容积(LAVmax)、最小容积(LAVmin)、主动排空分数(LAAEF)及被动排空分数(LAPEF)变化差异无统计学意义(P>0.05);术后1月,LAVp、LAVmax、LAVmin和LAAEF减小,LAPEF增加,差异均有统计学意义(P<0.05);术后3月,上述指标变化更为显著,差异均有统计学意义(P<0.01).与术前比较,术后1周SRs、SRe和SRa差异无统计学意义(P>0.05),术后1月SRs和SRe升高、SRa降低,差异均有统计学意义(P<0.05);术后3月SRs和SRe升高更为显著,SRa降低更明显,差异均有统计学意义(P<0.01).与术前比较,术后1月、3月左室射血分数的变化率分别与SRa的变化率呈显著负相关(r=-0.751,-0.783,均P<0.01).结论 CABG术可影响冠心病患者左心房功能,表现为储蓄功能和辅泵功能减低,管道功能增加.SRI可以评价左心房功能,动态观察CABG手术前、后左心房功能的变化.
목적 응용응변솔성상(SRI)기술평개관상동맥탑교(CABG)대관심병환자좌심방공능적영향.방법 분별우CABG술전、술후1주、1월화3월응용SRI기술대23례관심병환자좌심방공능진행평개.결과 여술전비교,술후I주좌심방수축기전용적(LAVp)、최대용적(LAVmax)、최소용적(LAVmin)、주동배공분수(LAAEF)급피동배공분수(LAPEF)변화차이무통계학의의(P>0.05);술후1월,LAVp、LAVmax、LAVmin화LAAEF감소,LAPEF증가,차이균유통계학의의(P<0.05);술후3월,상술지표변화경위현저,차이균유통계학의의(P<0.01).여술전비교,술후1주SRs、SRe화SRa차이무통계학의의(P>0.05),술후1월SRs화SRe승고、SRa강저,차이균유통계학의의(P<0.05);술후3월SRs화SRe승고경위현저,SRa강저경명현,차이균유통계학의의(P<0.01).여술전비교,술후1월、3월좌실사혈분수적변화솔분별여SRa적변화솔정현저부상관(r=-0.751,-0.783,균P<0.01).결론 CABG술가영향관심병환자좌심방공능,표현위저축공능화보빙공능감저,관도공능증가.SRI가이평개좌심방공능,동태관찰CABG수술전、후좌심방공능적변화.
Objective To explore the effect of coronary artery bypass grafting(CABG) on left atrial (LA) function by strain rate imaging(SRI). Methods Twenty-three patients with coronary heart disease who underwent coronary artery bypass grafting were involved. SRI was performed on those patients to evaluate LA function quantitatively at baseline (before CABG),and at 1 week, 1 month and 3 months after CABG. Peak strain rate(SR) was measured at each segment (septal, lateral, posterior, anterior, and inferior walls) and mean peak systolic SR (SRs),peak early diastolic SR (SRe) and peak atrial systolic SR (SRa) were calculated by averaging data in each segment. Results Compared with the baseline,LV pre-systolic volume(LAVp), maximal volume (LAVmax), minimal volume (LAVmin), LV active emptying fraction (LAAEF) and passive empting fraction(LAPEF) had on significant differences at 1 week (P >0.05). LAVp,LAVmin,LAVmax and LAAEF decreased gradually after CABG, LAPEF increased gradually after CABG (P <0.05). Compared with the baseline, the peaks of SR curve showed no significant differences at 1 week (P >0.05). Nevertheless,the peaks of SR were increased at systole and early diastole,decreased at atrial contraction at 1 month (P <0.05). Those changes were turned more significantly at 3 months (P 0.01). Left ventricular ejection fraction (LVEF) both increased at 1 month and 3 months,and its changing rate correlated inversely with the changing rate of SRa respectively (r = -0.751, -0.783,all P<0.01).Conclusions LA function is affected by CABG, presented as reservoir and pump functions decreased and conduit function increased. SRI can evaluate the atrial function quantitatively and monitor the changing of LA function dynamically after CABG.