CAJ | 학술논문

目的运用二维斑点追踪技术（STI）径向及圆周应变量化评价冠状动脉慢性完全闭塞（CTO）患者经皮冠状动脉介入治疗（PCI）前后左室心肌室壁运动功能变化，同时评价PCI治疗的效果。方法选择35例CTO患者，应用常规二维心动图检测PCI治疗术前、术后左室射血分数（LVEF）及室壁运动指数（WMSI）；STI检测术前、术后左室基底水平、乳头肌水平及心尖部水平收缩期峰值径向（RS）及圆周应变（CS）。结果（1）PCI治疗后CTO患者LVEF由治疗前（48．7％±6．90％）显著提高至（55．3％±7．31％）（P＜0．05）；左室 WMSI由治疗前（1．52±0．17）显著降低至（1．33±0．25）（P＜0．05）；（2）PCI治疗后CTO患者基底水平、乳头肌水平、心尖水平部分室壁节段RS及CS与术前比较显著升高（P＜0．05）；运动减弱和运动消失节段RS和CS及运动正常节段RS与术前比较显著升高（P＜0．05）。结论 STI技术能够准确定量评价CTO患者PCI治疗后左室心肌室壁运动功能，同时血管介入重建治疗可改善CTO患者左室心肌运动及功能。
목적운용이유반점추종기술（STI）경향급원주응변양화평개관상동맥만성완전폐새（CTO）환자경피관상동맥개입치료（PCI）전후좌실심기실벽운동공능변화，동시평개PCI치료적효과。방법선택35례CTO환자，응용상규이유심동도검측PCI치료술전、술후좌실사혈분수（LVEF）급실벽운동지수（WMSI）；STI검측술전、술후좌실기저수평、유두기수평급심첨부수평수축기봉치경향（RS）급원주응변（CS）。결과（1）PCI치료후CTO환자LVEF유치료전（48．7％±6．90％）현저제고지（55．3％±7．31％）（P＜0．05）；좌실 WMSI유치료전（1．52±0．17）현저강저지（1．33±0．25）（P＜0．05）；（2）PCI치료후CTO환자기저수평、유두기수평、심첨수평부분실벽절단RS급CS여술전비교현저승고（P＜0．05）；운동감약화운동소실절단RS화CS급운동정상절단RS여술전비교현저승고（P＜0．05）。결론 STI기술능구준학정량평개CTO환자PCI치료후좌실심기실벽운동공능，동시혈관개입중건치료가개선CTO환자좌실심기운동급공능。
Objective To evaluate the changes of left ventricular myocardial motion and function with two-dimensional speckle tracking imaging before and after percutaneous coronary intervention (PCI) in patients with chronic total occlusion(CTO) and the effect of recanalization of CTO by PCI . Methods Thirty-five patients with chronic total occlusion were enrolled in this study ,The left ventricular ejection fraction(LVEF) and wall motion score index (WMSI) were measured with two-dimensional echocardio-graphy before and after PCI ;The left ventricular radial strain(RS) and circumferential stain(CS) in wall segments at the levels of base ,apillary muscle and apical were measured before and after PCI . Results (1) The LVEF increased significantly from (48 .7 ± 6 .90 )% before PCI to (55 .3 ± 7 .31 )% after PCI (P<0 .05);The left ventricular WMSI decreased significantly from (1 .52 ± 0 .17) before PCI to (1 .33 ± 0 .25) after PCI (P<0 .05);(2)The left ventricular RS and CS values in part of wall segments at the levels of base ,papillary muscle and apical increased significantly after PCI (P<0 .05) ,The left ven-tricular RS and CS values in hypokinetic ,akinetic wall segments and RS values in normal wall segments in-creased significantly after PCI (P<0 .05) . Conclusion The left ventricular myocardial motion can be ac-curately and quantitatively evaluated with STI before and after PCI in patients with CTO . Recanalization by PCI can improve left ventricular myocardial motion and the left ventricular function in patients with CTO .