CAJ | 학술논문

目的应用二维斑点追踪技术评价左室射血分数(left ventricular ejection fraction,LVEF)正常的冠心病患者左室旋转/扭转功能及经皮冠脉支架植入(percutaneous coronary intervention,PCI)术后的早期变化.方法正常志愿者11例(A组),23例行择期冠脉造影且LVEF正常的冠心病患者,分为轻度冠脉狭窄组(B组)与重度冠脉狭窄组(C组),对比3组二尖瓣水平旋转峰值角度(peak basal rotation,BR)、心尖水平旋转峰值角度(peak apical rotation,AR)、左室扭转峰值角度(peak left ventricular torsion,LVT)及标化达峰时间;将LVT与上述指标行相关性分析;对比C组PCI 24 h后上述指标变化.结果 B组及C组AR和LVT较A组降低;C组二尖瓣水平扭转达峰时间较A组及B组提前(P＜0.05);LVT与AR、BR、二尖瓣水平旋转达峰时间相关;PCI后C组BR及LVT增加.结论 AR对缺血损伤敏感;LVEF正常的PCI患者二尖瓣水平达峰时间提前,可能既有代偿机制又有缺血心肌的限制;PCI后24 h BR对再灌注治疗敏感,可早期预测PCI后24 h的疗效.
목적 응용이유반점추종기술평개좌실사혈분수(left ventricular ejection fraction,LVEF)정상적관심병환자좌실선전/뉴전공능급경피관맥지가식입(percutaneous coronary intervention,PCI)술후적조기변화.방법 정상지원자11례(A조),23례행택기관맥조영차LVEF정상적관심병환자,분위경도관맥협착조(B조)여중도관맥협착조(C조),대비3조이첨판수평선전봉치각도(peak basal rotation,BR)、심첨수평선전봉치각도(peak apical rotation,AR)、좌실뉴전봉치각도(peak left ventricular torsion,LVT)급표화체봉시간;장LVT여상술지표행상관성분석;대비C조PCI 24 h후상술지표변화.결과 B조급C조AR화LVT교A조강저;C조이첨판수평뉴전체봉시간교A조급B조제전(P＜0.05);LVT여AR、BR、이첨판수평선전체봉시간상관;PCI후C조BR급LVT증가.결론 AR대결혈손상민감;LVEF정상적PCI환자이첨판수평체봉시간제전,가능기유대상궤제우유결혈심기적한제;PCI후24 h BR대재관주치료민감,가조기예측PCI후24 h적료효.
Objective To evaluate left ventricular rotation and torsion and its early recovery after percutaneous coronary intervention (PCI) in patients with coronary heart disease and normal left ventricular ejection fraction (LVEF) using two dimensional speckle tracking echocardiography.Methods Twenty three consecutive patients with coronary heart disease and normal LVEF were divided into group B (with coronary stenosis ＜70％) and group C (with coronary stenosis ＞70％ and with PCI).Along with 11 healthy controls(group A),indices including basal rotation (BR),apical rotation (AR),left ventricular torsion (LVT) and normalized time to peak were compared among groups,correlative analysis was made between LVT and each indices mentioned above,indices of group C before and 24 hours after PCI were compared.Results AR,LVT in group B and C reduced relative to group A (P ＜0.05),meanwhile time to peak of BR in group C shortened relative to other groups.BR,AR and normalized time to peak of BR were correlated to LVT respectively.BR and LVT in group C increased after PCI(P ＜0.05).Conclusions AR was sensitive to ischemia,the reduction of time to peak of BR in group C might be restriction and compensation.Sensitive to early recovery of left ventricular function after reperfusion,BR could be a predictive index of early effect of percutaneous coronary intervention.