CAJ | 학술논문

目的探讨速度向量成像(VVI)技术评价冠心病患者整体功能及介入治疗后的变化。方法选择18例正常成人和22例冠心病患者作为研究对象。在VVI成像模式下采集标准经胸心尖四腔观、二腔观和胸骨旁二尖瓣尖、心尖水平的左室短轴二维动态图像。所有冠心病患者分别于经皮冠状动脉介入治疗(PCI)前1d及治疗后1周、1个月、3个月时采集图像，应用VVI软件测量左室旋转运动的心底、心尖旋转角度、旋转速率，计算左室扭转角度和扭距等整体运动信息。结果心肌梗死组左室射血分数(LVEF)和左室扭矩(Ptor)均低于正常人和非心肌梗死组。PCI术后心肌梗死组和非心肌梗死组的LVEF均逐渐改善，心尖旋转角度、心尖旋转速率、左室扭转角度和Ptor变化趋势却相反：前者为术后1周或1个月内增高，术后3个月降低的趋势；后者为术后1周降低，术后1个月、3个月又逐渐增高的趋势。结论 VVI技术能定量评价左室扭转运动。与LVEF相比，左室扭转和扭矩更能体现两组冠心病患者在冠脉再通后左室整体收缩功能恢复过程中的不同特点。
목적 탐토속도향량성상(VVI)기술평개관심병환자정체공능급개입치료후적변화。방법 선택18례정상성인화22례관심병환자작위연구대상。재VVI성상모식하채집표준경흉심첨사강관、이강관화흉골방이첨판첨、심첨수평적좌실단축이유동태도상。소유관심병환자분별우경피관상동맥개입치료(PCI)전1d급치료후1주、1개월、3개월시채집도상，응용VVI연건측량좌실선전운동적심저、심첨선전각도、선전속솔，계산좌실뉴전각도화뉴거등정체운동신식。결과 심기경사조좌실사혈분수(LVEF)화좌실뉴구(Ptor)균저우정상인화비심기경사조。PCI술후심기경사조화비심기경사조적LVEF균축점개선，심첨선전각도、심첨선전속솔、좌실뉴전각도화Ptor변화추세각상반：전자위술후1주혹1개월내증고，술후3개월강저적추세；후자위술후1주강저，술후1개월、3개월우축점증고적추세。결론 VVI기술능정량평개좌실뉴전운동。여LVEF상비，좌실뉴전화뉴구경능체현량조관심병환자재관맥재통후좌실정체수축공능회복과정중적불동특점。
Objective To analyze left ventricular (LV) global systolic function in patients with coronary artery disease(CAD) and their changes after percutaneous coronary intervention(PCI) using velocity vector imaging(VVI). Methods Eighteen healthy adults and twenty two patients with CAD were enrolled in this study. Two-dimensional dynamic images of standard apical four-chambers, two-chambers and parasternal short-axis views at the level of mitral valve and apex were obtained in VVI condition. All patients were examined 1 day before PCI, 1 week, 1 month and 3 months after PCI respectively. LV rotation degree, rotation velocity at baseline and apex were measured using the off-line syngo US workplace software and LV twist, torsion were calculated as global motion condition. Results LV ejection fraction(LVEF) and peak torsion at myocardial infarction group were lower than those at normal control and myocardial ischemia group. After PCI, LVEF were gradually improved in both myocardial infarction group and myocardial ischemia group,while changes of LV apex rotation degree and velocity, peak twist and peak torsion between two groups were opposite: those parameters of the former increased 1 week or 1 month after PCI but decreased 3 months after PCI,while those of the latter decreased 1 week after PCI but increased gradually 1 month and 3 months after PCI. Conclusions LV twist and torsion can be evaluated exactly by VVI.Compared with LVEF, LV twist and torsion can preferably reflect the different characteristic of LV global systolic function after coronary artery recanalization in myocardial infarction group and myocardial ischemia group.