摘要
目的应用斑点追踪技术对ST段抬高及非ST段抬高心肌梗死患者介入治疗前后心内膜、心外膜旋转角度峰值变化进行评价，以探讨两种心肌梗死的透壁程度。方法研究共分3组：A组为20例正常人；B、C组分别为26例ST段抬高及22例非ST段抬高心肌梗死患者。A组及B、C组术前、术后1月分别行常规超声检查后，获取左室心尖部及基底部各3个心动周期的二维图像，最后应用工作站QLab软件脱机分析，得到心尖、心底及左室心内、外膜旋转角度。结果无论在心尖部、基底部，还是在左室整体，B、C组术前心内、外膜旋转角度峰值均明显低于A组（P〈0．01）。介入治疗后1月，仅C组的心尖及左室心外膜旋转角度峰值较术前显著改善（P〈0．01）。左室心外膜扭转角度峰值与射血分数呈正相关（r=0．63，P〈0．05），与室壁运动积分指数呈负相关（r=-0．85，P〈0．01）。结论应用斑点追踪技术测定心内、外膜旋转角度峰值能较好地反映ST段抬高及非ST段抬高心肌梗死透壁程度，且与心功能及室壁运动存在一定关系。
Objective To differentiate the transmural extent of myocardial necrosis by assessment of endocardial and epicardial rotation using speckle tracking imaging（STI） between ST-segment elevation acute myocardial infarction（STEAMI） and non-ST-elevation acute myocardial infarction（NSTEAMI）. Methods The study comprised 21） controls （group A）,26 patients with STEAMI （group B） and 22 patients with NSTEAMI （group C）. Conventional echocardiography and STI were done in controls and in patients before and one month after percutaneous coronary intervention（PCI）. Results In the apex,base of left ventricle （LV）, peak rotation and torsion of the endocardium（endo） and epicardium（epi） in groups B and C were both significantly reduced relative to those of group A before PCI （all P 〈0.01 ）. One month after PCI, there were no significant changes except peak apical epi rotation and peak LV epi-torsion in group C （all P 〈0.01）. Peak LV epi torsion was positively correlated with LV ejection fraction（LVEF）（ r = 0. 63, P〈 0.05） and inversely correlated with wall motion score index（ r = -0. 85, P 〈0. 01 ）. Conclusions Peak endo- and epi-rotation can contribute to estimation of transmural extent of necrosis between STEAMI and NSTEAMI using STI. Significant correlation is noted between peak LV torsion and myocardial contractile performance.
出处
《中华超声影像学杂志》
CSCD
北大核心
2010年第2期93-97,共5页
Chinese Journal of Ultrasonography
关键词
超声心动描记术
心肌梗死
旋转
扭转
斑点追踪显像
Echocardiography
Myocardial infarction
Rotation
Torsion
Speckle tracking imaging
