期刊文献+

二维斑点追踪技术评价急性心肌梗死患者介入治疗近期与中远期左心室功能改善 被引量:4

Assessment of left ventricular function early and late improvement of acute myocardial infarction after percutaneous coronary intervention by two-dimensional speckle tracking imaging
原文传递
导出
摘要 目的应用二维斑点追踪技术(STI)评价经皮冠状动脉介入术(PCI)治疗后急性心肌梗死(AMI)患者左心室功能变化,探讨STI评价AMI患者随访时心功能变化特点。方法采集73例经PCI治疗首发AMI患者术前、术后3个月及6个月左室图像,分析峰值纵向应变(LPSS)、峰值径向应变(RPSS)及峰值环向应变(CPSS),以术后6个月左室射血分数(LVEF)与术前相比(△LVEF6)改善幅度〉5%分为心功能改善组和非改善组;术后3个月LVEF与术前相比(△LVEF3)改善幅度〉5%将改善组分为近期和中远期改善组。结果改善组术前、术后STI各项参数均高于非改善组(P〈0.001)。近期改善组术前、术后LPSS及术后3个月RPSS均高于中远期改善组(3个月时LPSSP〈0.001,余参数P〈0.05)。STI各项参数均与△LVEF3和△LVEF6存在相关性,其中术前LPSS与△LVER相关性较大(r=-0.781,P〈0.001),术后6个月CPSS与△LVEF6相关性较大(r=-0.834,P〈0.001)。结论STI技术能准确评价AMI患者近期及中远期室壁运动变化;心肌梗死后左室纵向运动功能的保留对心功能近期改善较为重要,环向运动功能的保留和恢复是中远期仍能持续改善的关键。 Objective To assess left ventricular function early and late improvement of patients with acute myocardial infarction (AMI) treated by pereutaneous coronary intervention (PCI) by speckle tracking imaging (STI). The clinical values of the assessment of STI for the prognosis and heart function improvement of AMI patients treated by PCI were discussed. Methods 73 AMI patients who had AMI for the first time and had been treated by primary PCI from September 2010 to July 2011 and were examined in the follow-ups from December 2010 to February 2012 in our hospital were enrolled. Dynamic images were acquired before PCI, at 3 months and 6 months after PCI and analyzed by STI. Dynamic images were analyzed for longitudinal peak systolic strain (LPSS),radial peak systolic strain (RPSS) and circumferential peak systolic strain (CPSS) values by STI. According to the comparison of left ventricular ejection fraction (LVEF) before PCI and 6 months after PCI, patients were divided into left ventricular function improved group (△LVEF6〉5%) and not-improved group. According to the comparison of LVEF before PCI and 3 months after PCI, improved group were divided into left ventricular function early-improved group (△LVEF3 〉5%) and late-improved group. Results The values of all STI parameters before PCI,3 months and 6 months after PCI in improved group were higher than those in not-improved group ( P〈0. 001 ,all). LPSS before PCI and at the follow-ups and RPSS at 3 months after PCI in early-improved group were higher than those in late-improved group (LPSS at 3 months after PCI: P〈0. 001 ;Other parameters: P G0.05). There were significant correlations between all STI parameters and both △LVEF3 and △LVEF6. LPSS before PCI was more closely related to △LVEF3 ( r = -0. 781, P〈0. 001). CPSS at 6 months after PCI was more closely related to △LVEF6 ( r = - 0. 834, P 〈0. 001). Conclusions Early and late function improvement of left ventricle in AMI patients who is treated by PCI are accurately assessed by STI. The precise analyses of longitudinal and circumferential movements in STI are important for cIinical diagnosis.
出处 《中华超声影像学杂志》 CSCD 北大核心 2012年第11期926-931,共6页 Chinese Journal of Ultrasonography
关键词 超声心动描记术 心肌梗死 血管成形术 经腔 经皮冠状动脉 斑点追踪显像 Echocardiography Myocardial infarction Angioplasty, transluminal, percutaneous coronary Speckle tracking imaging
  • 相关文献

参考文献12

  • 1王吉耀.冠状动脉粥样硬化性心脏病.见:王吉耀.内科学.北京:人民卫生出版社,2008:257-296.
  • 2Norell MS, Perrins J, Meier B, et al. Essential interventional cardiology. 2nd ed. Philadelphia : Saunders/Elsevier, 2008 13-27.
  • 3Gaudron P,Eilles C, Kugler I, et aI. Progressive left ventricnlar dysfunction and remodeling after myocardial infarction potential mechanisms and early predictors. Circulation, 1993,87 : 755 763.
  • 4Pavlopoulos H, Nihoyannopoulos P. Strain and strain rate deformation parameters: from tissue Doppler to 2D speckle tracking. Cardiovasc Imaging, 2(}08,24 : 479-491.
  • 5Dandel M, Hetzer R. Echocardiographic strain and strain rate imaging clinical applications. Int J Cardio1,2009,132 : 1 l 24.
  • 6Winter R, Jussila R, Nowak J, et al. Speckle tracking echocardiography is a sensitive tool for the detection of myocardial ischemia: a pilot study from the catheterization laboratory during percutaneous coronary intervention. J Am Soc Echocardiogr, 20i)7,20 : 974-98l.
  • 7D'Andrea A, Cocchia R, Caso P, et al. Global longitudinal speckle-tracking strain is predictive of left ventricular remodeling after coronary angioplasty in patients with recent non-ST elevation myocardial infarction, lnt J Cardiol,2010, doi : 10.1016/ j. ijcard. 2010.08. 025.
  • 8Mollerna SA, Delgado V, Bertini M, et al. Viability assessment with global left ventricular longitudinal strain predicts recovery of left ventricular function after acute myocardial infarction. Circ Cardiovasc Imaging, 2010,3 : 15-23.
  • 9Antoni ML, Mollema SA, Atary JZ, et al. Time course of global left ventricular strain after acute myocardial infarction. Eur Heart J ,2010,31 .2006-2013.
  • 10Hung CL, Verrna A, Uno H, et al. Longitudinal and circumferential strain rate, left ventricular remodeling and prognosis after myocardial infarction. J Am Coil Cardiol, 2010, 56:1812-1822.

共引文献2

同被引文献32

引证文献4

二级引证文献21

相关作者

内容加载中请稍等...

相关机构

内容加载中请稍等...

相关主题

内容加载中请稍等...

浏览历史

内容加载中请稍等...
;
使用帮助 返回顶部