摘要
目的应用组织多普勒成像(TDI)评价择期冠状动脉介入治疗(PCI)对急性ST段抬高型心肌梗死(ASTEMI)患者左心室收缩、舒张功能及同步性的短期影响。方法收集因首次ASTEMI住院并接受择期PCI治疗的患者51例。根据冠状动脉造影及室壁运动状态将心肌分为梗死组(MI组,n=89)、缺血组(ISCHE组,n=93)及对照组(Con组,n=117)。于术前3 d内及术后1个月行常规超声和TDI检查。测得左心室整体收缩及舒张功能指标、左心室局部心肌功能指标及收缩同步性指标进行比较。结果术后1个月,左心室舒张末内径(LVEDD)、收缩末内径(LVESD)及收缩末容积(LVESV)缩小[(56.00±2.95)mm vs.(54.42±3.50)mm;(33.83±4.24)mm vs.(31.42±3.82)mm;(45.58±9.40)ml vs.(43.25±9.64)ml;P<0.05];射血分数(LVEF)增加[(56.42±5.93)%vs.(58.92±5.32)%,P<0.01];二尖瓣环收缩期峰速度(S'a)增加[(8.60±2.25)cm/s vs.(11.86±2.66)cm/s,P<0.05];二尖瓣舒张早期血流速度/二尖瓣环舒张期峰速度(E/Ea)减小(6.91±1.06 vs.5.52±1.18,P<0.01);左心室12节段收缩期纵向速度达峰时间标准差T-SD有减小趋势,但未见统计学差异[(42.37±20.41)ms vs.(37.60±17.07)ms,P>0.05]。ISCHE组心肌应变(S)增加[(12.73±4.96)%vs.(15.02±4.70)%,P<0.05],但MI组无变化[(11.33±4.99)%vs.(12.56±5.10)%,P>0.05]。结论择期PCI可短期内改善ASTEMI患者左心室整体收缩、舒张功能和缺血心肌的功能。组织应变成像(SI)可敏感、准确地评价左心室整体及局部心肌功能。
Objective To investigate the impact of elective percutaneous coronary intervention（PCI） on left ventricular function and synchronicity in acute ST-elevation myocardial infarction （ASTEMI）patients using tissue Doppler imaging （TDI）.Methods Fifty-one consecutive patients admitted with first-time ASTMI and undertook elective PCI were included.TDI parameters were determined three days before PCI and one month follow-up.All myocardial segments were divided into myocardial infarction（MI） group（n =89）,ischemia（ISCHE） group（n =93）and control（Con） group（n =117）.Results At one month follow-up,LV end-diastolic diameter（LVEDD）,LV endsystolic diameter（LVESD） and LV end-systolic volume （LVESV） decreased [（56.00 ± 2.95）mm vs.（54.42 ±3.50）mm;（33.83 ±4.24）mm vs.（31.42 ±3.82）mm;（45.58 ±9.40） ml vs.（43.25 ±9.64）ml;P 〈0.05] ;LVEF increased [（56.42 ±5.93）% vs.（58.92 ±5.32）% ;P 〈0.01] ;and systolic peak-velocity of mitral annulus （S＇a） increased [（8.60 ± 2.25） cm/s vs.（11.86 ± 2.66） cm/s; P 〈 0.05] ; transmitral to mitral annular early diastolic velocity ratio （E/Ea） decreased （6.91 ± 1.06 vs.5.52 ± 1.18,P 〈 0.01）.Strain （S） of ISCHE group increased [（12.73 ± 4.96） % vs.（15.02 ± 4.70） % ; P 〈 0.05],while no significant differences were observed in the MI group [（11.33 ± 4.99） % vs.（12.56 ± 5.10） %,P 〉 0.05] ; the standard deviation of the time to peak systolic velocity in a 12-segmental model of LV（T-SD） decreased,but was of no significantly statistical difference [（42.37 ＋20.41）ms vs.（37.60 ± 17.07）ms,P 〉0.05].Conclusion Elective PCI application on ischemic myocardial segments led to an improved LV global and segmemal systolic function in short term.Strain imaging（SI）could accurately determine LV global and segmental function.
出处
《中华临床医师杂志（电子版）》
CAS
2013年第11期35-38,共4页
Chinese Journal of Clinicians(Electronic Edition)
关键词
心肌梗死
血管成形术
经腔
经皮冠状动脉
超声心动描记术
多普勒
应变
同步性
Myocardial infarction
Angioplasty, transluminal, percutaneous coronary
Echocardiography,Doppler
Strain
Synchronicity
