CAJ | 학술논문

目的应用定量组织速度成像(QTVI)技术探讨冠心病患者PTCA支架置入后缺血节段心肌运动的同步性变化及其对心功能的影响.方法左前降支单支病变狭窄率≥75%患者36例,分别于支架治疗前3 d及治疗后1周、1个月应用Q TVI曲线测量左室心肌5个节段的收缩期峰值速度(Vs)、舒张早期峰值速度(Ve)、舒张晚期峰值速度(Va)、收缩期同步性指标(Ts)并计算Ts标准差(Ts-SD).结果冠心病患者各节段Vs、Ve、Va值均较低,Ve/Va倒置;支架置入治疗1周后,各节段Vs、Ve值均较术前升高(P＜0.05),Ve/Va值恢复.治疗后1月.速度指标继续增高,Vs、Ve均较术前差异有统计学意义(P＜0.01),与治疗后1周比较(P＜0.05),Va均无明显变化.术前不同步指标Ts明显延长.治疗后1周、1月均较术前明显缩短,差异有统计学意义(分别P＜0.05.P＜0.01).结论 QTVI技术能够定量分析冠心病患者缺血心肌运动及室壁同步性,监测PTCA术后心脏功能和同步性变化.
목적 응용정량조직속도성상(QTVI)기술탐토관심병환자PTCA지가치입후결혈절단심기운동적동보성변화급기대심공능적영향.방법 좌전강지단지병변협착솔≥75%환자36례,분별우지가치료전3 d급치료후1주、1개월응용Q TVI곡선측량좌실심기5개절단적수축기봉치속도(Vs)、서장조기봉치속도(Ve)、서장만기봉치속도(Va)、수축기동보성지표(Ts)병계산Ts표준차(Ts-SD).결과 관심병환자각절단Vs、Ve、Va치균교저,Ve/Va도치;지가치입치료1주후,각절단Vs、Ve치균교술전승고(P＜0.05),Ve/Va치회복.치료후1월.속도지표계속증고,Vs、Ve균교술전차이유통계학의의(P＜0.01),여치료후1주비교(P＜0.05),Va균무명현변화.술전불동보지표Ts명현연장.치료후1주、1월균교술전명현축단,차이유통계학의의(분별P＜0.05.P＜0.01).결론 QTVI기술능구정량분석관심병환자결혈심기운동급실벽동보성,감측PTCA술후심장공능화동보성변화.
Objective To evaluate the left ventricular function and the synchrony of myocardial ischemic segments in patients with coronary heart disease (CHD) after PTCA and stent implantation by quantitative tissue velocity imaging (QTVI). Methods Thirty-six patients with isolated left anterior descending stenosis (≥75%) were examined by QTVI three days before, one week and one month after successful PTCA and stent implantation to measure the following items of 5 different left ventricular segments: peak systolic velocity( Vs), early diastolic velocity (Ve), late diastolic velocity (Va), time to peak systolic velocity(Ts). Then the coefficient of variation (SD/mean) of the 5 different Ts were calculated.Results The value of Vs,Ve and Va were decreased and the Ve/Va ratio was reverses three days before PTCA + stent. Compared with that before PTCA + stent,the value of Vs and Ve were increased significantly in one week ( P ＜0. 05) and one month( P ＜0.01 ) after PTCA + stent,respectively,the value of Va was not statistically significant. Ve/Va ratio was recovered in one week after PTCA treatment. Ts and Ts-SD were shorted dramatically in one week( P ＜0. 05) and one month( P ＜0.01 ) after PTCA + stent compared with that before PTCA + stent in which Ts were prolonged more than 33 ms. Conclusions QTVI can quantitatively assess the left ventricular function and the synchrony of myocardial ischemic segments, and can be used to real-time detect the changes of function and synchrony of left ventricle after PTCA and stent implantation.