CAJ | 학술논문

目的:探讨超声二维斑点追踪显像(STI)技术诊断局部心室肌运动异常的临床价值.方法:根据冠状动脉造影(CAG)结果将入选患者分组.对照组为CAG示冠状动脉正常者25例,缺血组为CAG示冠状动脉左前降支(LAD)狭窄975%者28例.分别记录心尖位四腔、长轴及两腔切面高帧频图像,应用STI技术测量重度冠状动脉狭窄患者的LAD供血区域各个节段心肌的收缩期纵向峰值应变及应变率.结果:对照组与缺血组成功获得二维应变及应变率的节段数分别为94.0%和93.3%.纵向峰值应变后间隔中间段.前间隔及前壁中间段、心尖段缺血组较对照组均明显减低,差异有统计学意义(P＜0.05);纵向峰值应变率前间隔及前壁中间段、心尖段缺血组较对照组均明显减低,差异有统计学意义(P＜0.05).结论:当冠状动脉出现严重狭窄时,STI技术能较好定位冠状动脉粥样硬化性心脏病患者的异常心肌节段,并显示无明显室壁运动异常的冠心病患者局部心肌收缩功能降低.
목적:탐토초성이유반점추종현상(STI)기술진단국부심실기운동이상적림상개치.방법:근거관상동맥조영(CAG)결과장입선환자분조.대조조위CAG시관상동맥정상자25례,결혈조위CAG시관상동맥좌전강지(LAD)협착975%자28례.분별기록심첨위사강、장축급량강절면고정빈도상,응용STI기술측량중도관상동맥협착환자적LAD공혈구역각개절단심기적수축기종향봉치응변급응변솔.결과:대조조여결혈조성공획득이유응변급응변솔적절단수분별위94.0%화93.3%.종향봉치응변후간격중간단.전간격급전벽중간단、심첨단결혈조교대조조균명현감저,차이유통계학의의(P＜0.05);종향봉치응변솔전간격급전벽중간단、심첨단결혈조교대조조균명현감저,차이유통계학의의(P＜0.05).결론:당관상동맥출현엄중협착시,STI기술능교호정위관상동맥죽양경화성심장병환자적이상심기절단,병현시무명현실벽운동이상적관심병환자국부심기수축공능강저.
Objective:To assess the myocardial strain and strain rate by two-dimensional speckle tracking imaging(STI)in patients with coronary artery disease(CAD).Methods:All of the subjects were underwent coronary angiography(CAG).There were 25 patients with normal coronary artery in control group;28 subjects with left anterior descending(LAD) stenosis≥75%in ischemic group.All of the subjects were prospectively imaged within 48 hours of CAG.Hiish frame rate two-dimen-sional images were recorded from the apical four-chamber view,long-axis view and two-chamber view of the left ventricle respectively.The peak systolic longitudinal strain(S_L) and strain rate(SR_L)of LAD segments were measured using Q-Lab 6.0 software.Results:Two-dimensional strain and strain rate were obtained in 209 of 224 segments with LAD regional walls in ischemic group;188 of 200 segments were obtained in control group.S_L of mid inferoseptal,mid and apical anteroseptal,mid and apical anterior segments were decreased in ischemic group compared with those of control group(P＜0.05).SR_L of mid and apical antemseptal,mid and apicM anterior segments were decreased in ischemie group compared with that of control group (P＜0.05).Conclusion:STI can detect abnormal myocardial segments more accurately,and evaluate the regional wall motion of the left ventricle in CAD patients.