Background Identifying the transmural extent of myocardial necrosis and the degree of myocardial viability in acute myocardial infarction （AMI） is important clinically. The aim of this study was to assess myocardial...Background Identifying the transmural extent of myocardial necrosis and the degree of myocardial viability in acute myocardial infarction （AMI） is important clinically. The aim of this study was to assess myocardial viability using two-dimensional speckle tracking imaging （2D-STI） in patients with AMI. Methods 2D-STI was performed at initial presentation, three days, and six months after primary percutaneous coronary intervention （PCI） in 30 patients with AMI, who had a left anterior descending coronary artery （LAD） culprit lesion. In addition, 20 patients who had minimal stenotic lesions （〈 30% stenosis） on coronary angiography were also included in the control group. At six months dobutamine echocardiography was performed for viability assessment in seven segments of the LAD territory. According to the recovery of wall motion abnormality, segments were classified as viable or non-viable. Results A total of 131 segments were viable, and 44 were nonviable. Multivariate analysis revealed significant differences between the viable and nonviable segments in the peak systolic strain, the peak systolic strain rate at initial presentation, and peak systolic strain rate three days after primary PCI. Among these, the initial peak systolic strain rate had the highest predictive value for myocardial viability （hazard ratio： 31.22, P 〈 0.01）. Conclusions 2D-STI is feasible for assessing myocardial viability, and the peak systolic strain rate might be the most reliable predictor of myocardial viability in patients with AMI.展开更多
Objective: To research the clinical application of two-dimensional speckle tracking imaging (2D-STI) in quantitative assessment of left ventricular function in patients with obstructive sleep apnea-hypopnea syndrome (...Objective: To research the clinical application of two-dimensional speckle tracking imaging (2D-STI) in quantitative assessment of left ventricular function in patients with obstructive sleep apnea-hypopnea syndrome (OSAS). Method: From July 2016 to December 2018, 86 patients with OSAS were selected as OSAS group. According to sleep apnea hypopnea index (AHI), they were divided into mild OSAS group (24 cases), moderate OSAS group (29 cases) and severe OSAS group (33 cases). Another 50 healthy volunteers who underwent physical examination in our hospital during the same period were selected as the control group. The left ventricular function of all patients was quantitatively assessed by 2D-STI. The left ventricular function of all patients was quantitatively assessed by 2D-STI. The results of routine echocardiography and left ventricular global strain parameters of the OSAS group, the control group and the OSAS patients with different severity were compared and analyzed. Result: There were no significant differences in the levels of left ventricular ejection fraction (LVEF), left ventricular end diastolic diameter (LVEDd), left ventricular end systolic diameter (LVESd) between the two groups and OSAS patients with different severity (P>0.05). The levels of IVST, LVPW and LVMI in the OSAS group were significantly higher than those in the control group, the levels of end-diastolic interventricular septal thickness (IVS), left ventricular posterior wall thickness (LVPW), left ventricular mass index (LVMI) in the severe OSAS group were significantly higher than those in the mild and moderate OSAS group, and the levels of IVST, LVPW and LVMI in the moderate OSAS group were significantly higher than those in the mild OSAS group, there were significant differences between groups (P<0.05). The levels of GLS, GRS and GCS in the OSAS group were significantly lower than those in the control group (P<0.05). GLS, GRS and GCS levels in the severe OSAS group were significantly lower than those in the mild OSAS group and the moderate OSAS group, while the levels of global longitudinal strain (GLS), global radial strain (GRS) and global circumferential strain (GCS) in the moderate OSAS group were significantly lower than those in the mild OSAS group (P<0.05). Conclusion: The left ventricular systolic function of OSAS patients is obviously impaired. Left ventricular function in OSAS patients can be assessed timely and accurately by two-dimensional speckle tracking imaging.展开更多
目的探讨四维超声自动左心房定量技术(Automatic left atrial quantification with four-dimensional ultrasound,4DAutoVQ)、三维斑点追踪成像技术(Three-dimensional speckle tracking imaging technology,3D-STI)在老年慢性心力衰竭(...目的探讨四维超声自动左心房定量技术(Automatic left atrial quantification with four-dimensional ultrasound,4DAutoVQ)、三维斑点追踪成像技术(Three-dimensional speckle tracking imaging technology,3D-STI)在老年慢性心力衰竭(Chronic heart failure,CHF)患者心功能评价中的应用价值。方法选取2020年1月至2022年4月重庆大学附属沙坪坝医院重庆市沙坪坝区人民医院心血管内科收治的老年CHF患者167例设为研究组,另选取同期健康体检者167例设为对照组。采集两组受检者性别、年龄、体质量指数(Body mass index,BMI)、舒张压、收缩压、研究组美国纽约心脏病学会(New York Heart Association,NYHA)分级等资料,实施3D-STI、4DAutoVQ检查。比较研究组与对照组、研究组不同NYHA分级患者4DAutoVQ、3D-STI参数,分析4DAutoVQ、3D-STI参数与研究组NYHA分级的关联性。结果(1)研究组左心室整体径向收缩期峰值应变(Global radial systolic peak strain of left ventricle,GRS)、整体环向收缩期峰值应变(Global circumferential peak systolic strain,GCS)、整体纵向收缩期峰值应变(Overall longitudinal peak systolic strain,GLS)、左房排空容积(Left atrial emptying volume,LAEV)、左房射血分数(Left atrial ejection fraction,LAEF)、左房被动射血分数(Left atrial passive ejection fraction,LAPEF)、左房主动射血分数(Left atrial active ejection fraction,LAAEF)、左房储备期纵向应变(Longitudinal strain of left atrial reserve,LASr)、左房储备期圆周应变(Peripheral strain of left atrial reserve period,LASr-c)低于对照组,左房最大容积指数(Maximum left atrial volume index,LAVImax)、左房最小容积(Minimum left atrial volume,LAVmin)、左房收缩前容积(Left atrial pre systolic volume,LAVpreA)、左房最大容积(Maximum left atrial volume,LAVmax)、左房通道期纵向应变(Longitudinal strain of left atrial passage,LAScd)、左房收缩期纵向应变(Longitudinal strain of left atrium during systole,LASct)、左房收缩期圆周应变(Left atrial systolic circumferential strain,LASct-c)、左房通道期圆周应变(Circumferential strain of left atrial passage,LAScd-c)高于对照组,差异有统计学意义(P<0.05)。(2)研究组不同NYHA分级患者4DAutoVQ、3D-STI参数比较,差异有统计学意义(P<0.05),且随着NYHA分级增高,GRS、GCS、GLS、LAEV、LAEF、LAPEF、LAAEF、LASr、LASr-c呈降低趋势,LAVImax、LAVmin、LAVpreA、LAVmax、LAScd、LASct、LASct-c、LAScd-c呈增高趋势,差异有统计学意义(P<0.05)。(3)Spearman相关性分析结果显示,GRS、GCS、GLS、LAEV、LAEF、LAPEF、LAAEF、LASr、LASr-c与CHF病情分级存在负相关关系,LAVImax、LAVmin、LAVpreA、LAVmax、LAScd、LASct、LASct-c、LAScd-c与CHF病情分级存在显著正相关关系(P<0.05)。(4)Logistic分析结果显示,GRS、GCS、GLS、LAEV、LAEF、LAPEF、LAAEF、LASr、LASr-c、LAVImax、LAVmin、LAVpreA、LAVmax、LAScd、LASct、LASct-c、LAScd-c均是CHF重要影响因素(P<0.05)。结论通过4DAutoVQ、3D-STI检查可评估老年CHF患者心功能及结构状态,相关参数增高或降低程度与疾病病情关系密切,可评估疾病NYHA分级。展开更多
文摘Background Identifying the transmural extent of myocardial necrosis and the degree of myocardial viability in acute myocardial infarction （AMI） is important clinically. The aim of this study was to assess myocardial viability using two-dimensional speckle tracking imaging （2D-STI） in patients with AMI. Methods 2D-STI was performed at initial presentation, three days, and six months after primary percutaneous coronary intervention （PCI） in 30 patients with AMI, who had a left anterior descending coronary artery （LAD） culprit lesion. In addition, 20 patients who had minimal stenotic lesions （〈 30% stenosis） on coronary angiography were also included in the control group. At six months dobutamine echocardiography was performed for viability assessment in seven segments of the LAD territory. According to the recovery of wall motion abnormality, segments were classified as viable or non-viable. Results A total of 131 segments were viable, and 44 were nonviable. Multivariate analysis revealed significant differences between the viable and nonviable segments in the peak systolic strain, the peak systolic strain rate at initial presentation, and peak systolic strain rate three days after primary PCI. Among these, the initial peak systolic strain rate had the highest predictive value for myocardial viability （hazard ratio： 31.22, P 〈 0.01）. Conclusions 2D-STI is feasible for assessing myocardial viability, and the peak systolic strain rate might be the most reliable predictor of myocardial viability in patients with AMI.
文摘Objective: To research the clinical application of two-dimensional speckle tracking imaging (2D-STI) in quantitative assessment of left ventricular function in patients with obstructive sleep apnea-hypopnea syndrome (OSAS). Method: From July 2016 to December 2018, 86 patients with OSAS were selected as OSAS group. According to sleep apnea hypopnea index (AHI), they were divided into mild OSAS group (24 cases), moderate OSAS group (29 cases) and severe OSAS group (33 cases). Another 50 healthy volunteers who underwent physical examination in our hospital during the same period were selected as the control group. The left ventricular function of all patients was quantitatively assessed by 2D-STI. The left ventricular function of all patients was quantitatively assessed by 2D-STI. The results of routine echocardiography and left ventricular global strain parameters of the OSAS group, the control group and the OSAS patients with different severity were compared and analyzed. Result: There were no significant differences in the levels of left ventricular ejection fraction (LVEF), left ventricular end diastolic diameter (LVEDd), left ventricular end systolic diameter (LVESd) between the two groups and OSAS patients with different severity (P>0.05). The levels of IVST, LVPW and LVMI in the OSAS group were significantly higher than those in the control group, the levels of end-diastolic interventricular septal thickness (IVS), left ventricular posterior wall thickness (LVPW), left ventricular mass index (LVMI) in the severe OSAS group were significantly higher than those in the mild and moderate OSAS group, and the levels of IVST, LVPW and LVMI in the moderate OSAS group were significantly higher than those in the mild OSAS group, there were significant differences between groups (P<0.05). The levels of GLS, GRS and GCS in the OSAS group were significantly lower than those in the control group (P<0.05). GLS, GRS and GCS levels in the severe OSAS group were significantly lower than those in the mild OSAS group and the moderate OSAS group, while the levels of global longitudinal strain (GLS), global radial strain (GRS) and global circumferential strain (GCS) in the moderate OSAS group were significantly lower than those in the mild OSAS group (P<0.05). Conclusion: The left ventricular systolic function of OSAS patients is obviously impaired. Left ventricular function in OSAS patients can be assessed timely and accurately by two-dimensional speckle tracking imaging.
文摘目的探讨四维超声自动左心房定量技术(Automatic left atrial quantification with four-dimensional ultrasound,4DAutoVQ)、三维斑点追踪成像技术(Three-dimensional speckle tracking imaging technology,3D-STI)在老年慢性心力衰竭(Chronic heart failure,CHF)患者心功能评价中的应用价值。方法选取2020年1月至2022年4月重庆大学附属沙坪坝医院重庆市沙坪坝区人民医院心血管内科收治的老年CHF患者167例设为研究组,另选取同期健康体检者167例设为对照组。采集两组受检者性别、年龄、体质量指数(Body mass index,BMI)、舒张压、收缩压、研究组美国纽约心脏病学会(New York Heart Association,NYHA)分级等资料,实施3D-STI、4DAutoVQ检查。比较研究组与对照组、研究组不同NYHA分级患者4DAutoVQ、3D-STI参数,分析4DAutoVQ、3D-STI参数与研究组NYHA分级的关联性。结果(1)研究组左心室整体径向收缩期峰值应变(Global radial systolic peak strain of left ventricle,GRS)、整体环向收缩期峰值应变(Global circumferential peak systolic strain,GCS)、整体纵向收缩期峰值应变(Overall longitudinal peak systolic strain,GLS)、左房排空容积(Left atrial emptying volume,LAEV)、左房射血分数(Left atrial ejection fraction,LAEF)、左房被动射血分数(Left atrial passive ejection fraction,LAPEF)、左房主动射血分数(Left atrial active ejection fraction,LAAEF)、左房储备期纵向应变(Longitudinal strain of left atrial reserve,LASr)、左房储备期圆周应变(Peripheral strain of left atrial reserve period,LASr-c)低于对照组,左房最大容积指数(Maximum left atrial volume index,LAVImax)、左房最小容积(Minimum left atrial volume,LAVmin)、左房收缩前容积(Left atrial pre systolic volume,LAVpreA)、左房最大容积(Maximum left atrial volume,LAVmax)、左房通道期纵向应变(Longitudinal strain of left atrial passage,LAScd)、左房收缩期纵向应变(Longitudinal strain of left atrium during systole,LASct)、左房收缩期圆周应变(Left atrial systolic circumferential strain,LASct-c)、左房通道期圆周应变(Circumferential strain of left atrial passage,LAScd-c)高于对照组,差异有统计学意义(P<0.05)。(2)研究组不同NYHA分级患者4DAutoVQ、3D-STI参数比较,差异有统计学意义(P<0.05),且随着NYHA分级增高,GRS、GCS、GLS、LAEV、LAEF、LAPEF、LAAEF、LASr、LASr-c呈降低趋势,LAVImax、LAVmin、LAVpreA、LAVmax、LAScd、LASct、LASct-c、LAScd-c呈增高趋势,差异有统计学意义(P<0.05)。(3)Spearman相关性分析结果显示,GRS、GCS、GLS、LAEV、LAEF、LAPEF、LAAEF、LASr、LASr-c与CHF病情分级存在负相关关系,LAVImax、LAVmin、LAVpreA、LAVmax、LAScd、LASct、LASct-c、LAScd-c与CHF病情分级存在显著正相关关系(P<0.05)。(4)Logistic分析结果显示,GRS、GCS、GLS、LAEV、LAEF、LAPEF、LAAEF、LASr、LASr-c、LAVImax、LAVmin、LAVpreA、LAVmax、LAScd、LASct、LASct-c、LAScd-c均是CHF重要影响因素(P<0.05)。结论通过4DAutoVQ、3D-STI检查可评估老年CHF患者心功能及结构状态,相关参数增高或降低程度与疾病病情关系密切,可评估疾病NYHA分级。
