摘要
目的探究三维斑点追踪成像(3D-STE)技术检测下左心室应变情况与急性心肌梗死患者冠脉病变程度、不良心脏事件的关系。方法选取海口市120急救中心2017年1月—2020年12月急性心肌梗死患者82例作为研究对象,分为轻度病变组(30例)、中度病变组(31例)、重度病变组(21例),比较三组临床资料、左心室应变参数[左室整体纵向应变(GLS)、整体径向应变(GRS)、整体面积应变(GAS)、整体圆周应变(GCS)],分析左心室应变参数与左心功能指标[左室射血分数(LVEF)、左室收缩末容积(LVESV)、左室舒张末容积(LVEDV)]及急性心肌梗死冠脉病变程度相关性,随访30 d,比较不同预后患者左心室应变参数,评价左心室应变参数对不良心脏事件的影响。结果重度病变组冠心病家族史、心电图ST-T改变、合并高血压、LVESV、LVEDV均高于中度病变组、轻度病变组,LVEF低于中度病变组、轻度病变组(均P<0.05);中度病变组冠心病家族史、心电图ST-T改变、合并高血压、LVESV、LVEDV均高于轻度病变组,LVEF低于轻度病变组(均P<0.05)。GLS绝对值、GRS、GAS绝对值、GCS绝对值与LVESV、LVEDV呈负相关,与LVEF呈正相关(P<0.05)。GLS、GRS、GAS、GCS与急性心肌梗死冠脉病变程度显著相关(P<0.05)。GLS、GRS、GAS、GCS与不良心脏事件显著相关(P<0.05)。结论3D-STE技术检测下左心室应变情况可为判断急性心肌梗死冠脉病变程度、预测不良心脏事件提供有力影像学支持。
Objective To investigate the relationship between left ventricular strain under three-dimensional speckle tracking imaging(3D-STE)technique and the degree of coronary lesions and adverse cardiac events in patients with acute myocardial infarction(AMI).Methods 82 patients with AMI were divided into 3 groups:mild lesion group(with the Gensini score<50,n=30),moderate lesion group(with the Gensini score 50~90,n=31),and severe lesion group(with the Gensini score>90,n=21).Color Doppler ultrasound diagnostic instrument was used to obtain the left-ventricular 3-dimensional full volume image.3D-STE image-analyzing soft was used to obtain the global longitudinal strain(GLS),global radial strain(GRS),global area strain(GAS),global circumferential strain(GCS),left ventricular ejection fraction(LVEF),left ventricular end-systolic volume(LVESV),and left ventricular end-diastolic volume(LVEDV).Related clinical data were collected.Single factor analysis of variance was used for comparison among groups,and Pearson correlation coefficient model was used for correlation analysis.Results Family history of coronary heart disease,ECG ST-T changes,combined hypertension,LVESV and LVEDV were higher in the severe lesion group than in the moderate lesion and mild lesion groups,and LVEF was lower than in the moderate lesion and mild lesion groups(all P<0.05);Family history of coronary heart disease,ECG ST-T changes,combined hypertension,LVESV and LVEDV were higher in the moderate lesion group than in the mild lesion group,and LVEF was lower than in the mild lesion group(all P<0.05).LVEF was lower than that of the mild lesion group(all P<0.05),and the LVEF level of the moderate group was significantly lower than that of the mild groups(P<0.05).The GLS,GRS,GAS,and GCS levels of the severe group were all significantly lower than thost of the moderate and mild groups(all P<0.05),and the GLS,GRS,GAS,and GCS levels of the moderate group were all significantly lower than those of the mild groups(all P<0.05).The absolute values of GLS,GRS,GAS,and GCS were all negatively correlated with LVESV and LVEDV,and positively correlated with LVEF(all P<0.05).The absolute values of GLS,GRS,GAS,and GCS were all significantly correlated with degree of coronary lesion in AMI(P<0.05).GLS,GRS,GAS and GCS were significantly associated with adverse cardiac events(P<0.05).Conclusion The left ventricular strain detected by 3D-STE technology can provide strong imaging support for judging the degree of coronary lesion in AMI and predicting adverse cardiac events.
作者
赵曼云
郭蔚虹
张霞
付杰
GUO Weihong;ZHANG Xia;FU Jie(Department of Emergency Medicine,Haikou 120 Emergency Center,Haikou Hainan 570208,China)
出处
《中国急救复苏与灾害医学杂志》
2023年第7期841-845,共5页
China Journal of Emergency Resuscitation and Disaster Medicine
基金
海南省医药卫生科研项目(编号:13A210350)。
关键词
三维斑点追踪成像技术
左心室应变
急性心肌梗死
冠脉病变程度
不良心脏事件
3D speckle tracking imaging
Left ventricular strain
Acute myocardial infarction
Degree of coronary lesion
Adverse cardiac events
