摘要
目的评价定量实时心肌声学造影结合小剂量多巴酚丁胺负荷试验在冠心病诊断中的价值;评价侧支循环对心肌灌注的影响。方法26例住院患者进行了常规超声心动图、基础状态下和小剂量多巴酚丁胺负荷状态下的心肌声学造影以及选择性冠状动脉造影。造影图像采用QLab软件对微泡再充盈曲线进行定量分析,求出各节段的A值、β值及其乘积A×β值。对各节段心肌灌注参数和其供血冠状动脉的狭窄程度进行统计学分析。结果基础状态下,β值和A×β值随着供血冠状动脉狭窄程度的增加而降低(P<0.01);在负荷状态下,A值、β值和A×β值随着供血冠状动脉狭窄程度的增加而降低(P<0.01),且其储备值呈现出相同的趋势(P<0.01);侧支循环的存在与否显著影响各节段的心肌灌注参数及其储备值,且在严重狭窄节段中尤为明显(P<0.01)。结论定量实时心肌声学造影结合小剂量多巴酚丁胺负荷试验可以作为一种敏感的手段用于冠心病临床诊断及其危险性评估。
ObjectiveTo evaluate the value of quantitative real-time myocardial contrast echocardiography (RT-MCE) combined with low dose dobutamine stress test in the detection of coronary artery disease (CAD), and to assess the contribution of collateral blood flow (CBF) to myocardial perfusion.Methods Twenty-six hospitalized patients referred for coronary angiography and subsequent revascularization underwent routine echocardiography, RT-MCE at baseline and after low dose dobutamine administration. The images of RT-MCE were analyzed quantitatively from microbubble replenishment curves for myocardial perfusion and its reserve by using the QLab software.Results At baseline, both β and A×β (but not A) were decreased with the increase of severity of coronary stenosis (P<0.01). Under dobutamine stress, A, β and A×β values were decreased with the increase of severity of coronary stenosis (P<0.01), Graded decreasing in the reserves of A, β and A×β were observed with increasing coronary stenosis severity (P<0.01). Furthermore, significant differences in β, A×β, and WMS were observed between segments with CBF and those without. Conclusion Quantitative RT-MCE in conjunction with dobutamine stress can be used as a sensitive measure to identify and stratify CAD as well as to assess the contribution of collateral blood flow.
出处
《中华心血管病杂志》
CAS
CSCD
北大核心
2005年第5期419-424,共6页
Chinese Journal of Cardiology
