CAJ | 학술논문

目的：探讨急性心肌梗死后各节段心肌圆周应变率（SrC）、径向应变率（SrR）及心肌扭转角度变化与左室射血分数（LVEF）的相关性。方法选取51例经冠脉造影证实的急性心肌梗死患者作为心肌梗死组，40例正常健康者作为对照组，使用二维超声斑点追踪技术分别测量心尖水平与瓣环水平左室短轴各节段心肌的圆周应变率、径向应变率、心肌扭转及 LVEF 指标，并分析急性心肌梗死后心肌应变率及左室扭转角度与左室射血分数的相关性。结果（1）急性心肌梗死组患者左室容积较对照组增大，但差异无统计学意义（P ＞0．05）；LVEF 较对照组下降，差异有统计学意义（P ＜0．05）。（2）急性心肌梗死组患者各节段心肌 SrC、SrR 较对照组均明显下降，差异有统计学意义（P ＜0．05）。（3）急性心肌梗死组患者各节段心肌扭转角度较对照组明显下降，差异有统计学意义（P ＜0．05）。（4）直线相关方程显示，急性心梗组患者各节段 SrC、SrR 及扭转角度均与 LVEF 具有相关性，其中左室整体扭转角度与 LVEF 相关性较好（P ＜0．05）。结论急性心肌梗死后心肌力学发生了严重改变，其中心肌扭转较应变率对心功能的影响更为明显。
목적：탐토급성심기경사후각절단심기원주응변솔（SrC）、경향응변솔（SrR）급심기뉴전각도변화여좌실사혈분수（LVEF）적상관성。방법선취51례경관맥조영증실적급성심기경사환자작위심기경사조，40례정상건강자작위대조조，사용이유초성반점추종기술분별측량심첨수평여판배수평좌실단축각절단심기적원주응변솔、경향응변솔、심기뉴전급 LVEF 지표，병분석급성심기경사후심기응변솔급좌실뉴전각도여좌실사혈분수적상관성。결과（1）급성심기경사조환자좌실용적교대조조증대，단차이무통계학의의（P ＞0．05）；LVEF 교대조조하강，차이유통계학의의（P ＜0．05）。（2）급성심기경사조환자각절단심기 SrC、SrR 교대조조균명현하강，차이유통계학의의（P ＜0．05）。（3）급성심기경사조환자각절단심기뉴전각도교대조조명현하강，차이유통계학의의（P ＜0．05）。（4）직선상관방정현시，급성심경조환자각절단 SrC、SrR 급뉴전각도균여 LVEF 구유상관성，기중좌실정체뉴전각도여 LVEF 상관성교호（P ＜0．05）。결론급성심기경사후심기역학발생료엄중개변，기중심기뉴전교응변솔대심공능적영향경위명현。
Objective To investigate the correlation between left ventricular ejection fraction (LVEF)and myocardial circumferential strain,radial strain rate,myocardial torsion angle after acute myocardial infarc-tion.Methods 51 cases suffered from acute myocardial infarction and confirmed by coronary angiography were chosen as myocardial infarction group,40 healthy patients as control group.Each segment of the my-ocardial circumferential strain rate,radial strain rate,left ventricular torsion and LVEF were measured by two - dimensional ultrasound speckle tracking technology at apical level and annulus level in left ventricular short axis view respectively,then observed the relativity among myocardial circumferential strain,radial strain rate,myocardial torsion angle and left ventricular ejection fraction (LVEF)after acute myocardial infarction.Results (1)Compared with the control group,there was enlargement in the LV volume in myocardial infarction group,but there was no statistical significance (P >0.05),while there was significant decrease in LVEF in myocardial infarction group (P > 0.05 ).(2)Compared with the control group,the circumferential and radial strain rate of each segment decreased significantly in myocar-dial infarction group (P <0.05).(3)Compared with the control group,the myocardial torsion angle of each segment decreased significantly in myocardial infarction group (P <0.05).(4)Linear correlation a-nalysis indicated that both strain rate and torsion angle of each segment myocardial had good correlations with LVEF,particularly presented in left ventricular torsion angle and LVEF (r =0.79 P <0.05).Conclu-sion After acute myocardial infarction happened,myocardial mechanics changed seriously,especially that myocardial torsion influenced cardiac function obviously.