摘要
目的探讨左心室三维应变在预测冠心病患者冠状动脉狭窄程度中的临床应用价值。方法行冠状动脉造影(coronary artery angiography,CAG)患者121例,依据CAG结果分为CAG阳性组和CAG阴性组;CAG检查前患者均应用三维斑点追踪技术行超声心动图检查,比较2组左心室三维节段纵向应变(three-dimensional segmental longitudinal strain,3D-LSS)、左心室三维节段面积应变(three-dimensional segmental area strain,3D-ASS)、左心室三维节段圆周应变(three-dimensional segmental circumferential strain,3D-CSS)及左心室三维节段径向应变(three-dimensional segmental radial strain,3D-RSS);绘制ROC曲线,分析左心室三维应变指标预测CAG阳性、冠状动脉中重度狭窄的价值。结果CAG阳性组左前降支、左回旋支及右冠状动脉|3D-LSS|[(18.2±2.6)%、(18.6±2.1)%、(17.7±3.1)%]低于CAG阴性组[(21.2±3.1)%、(21.7±2.8)%、(20.7±2.7)%],|3D-ASS|[(27.3±6.3)%、(26.1±5.7)%、(26.2±8.1)%]低于CAG阴性组[(33.6±7.2)%、(34.2±6.9)%、(32.8±6.9)%],差异均有统计学意义(P<0.05);2组左前降支、左回旋支及右冠状动脉|3D-CSS|与3D-RSS比较差异无统计学意义(P>0.05);ROC曲线分析结果显示,左心室3D-LSS(截点值=-17%)和3D-ASS(截点值=-27%)预测CAG阳性的灵敏度、特异度和AUC分别为55.2%、74.1%、0.702和61.2%、72.2%、0.692;左心室3D-LSS(截点值=-17%)和3D-ASS(截点值=-27%)预测冠状动脉中重度狭窄的灵敏度、特异度和AUC分别为71.9%、81.3%、0.817和76.7%、82.9%、0.809。结论 3D-LSS和3D-ASS对冠心病预测有一定价值,在预测冠状动脉中重度狭窄中有较高的灵敏度和特异度。
Objective To evaluate the clinical value of left ventricular three-dimensional strain to predicting the degree of coronary stenosis in patients with coronary heart disease. Methods A total of 121 patients undergoing coronary angiography （CAG） were divided into positive CAG group and negative CAG group. Three dimensional speckle tracking technique was performed before CAG to compare three-dimensional segmental longitudinal strain （3D-LSS）, three-dimensional segmental radial strain （3D-RSS）, three-dimensional segmental area strain （3D-ASS） and three-dimensional segmental circumferential strain （3D-CSS）. The values of left ventricular three-dimensional strain indexes for predicting positive CAG and moderate and severe coronary artery stenosis were analyzed according to ROCcurves. Results ｜3D-LSS｜ and ｜3S-ANa｜ values of left anterior descending artery （LAD） （（18.2±2.6）%, （27.3±6.3）%）, left circumflex artery （LCA） （（18.6±2.1）%, （26.1±5.7）%） and right coronary artery （RCA） （（17.7±3.1） %, （26.2 ±8. 1）%） in positive CAG group were significantly lower than those in negative CAG group （（21.2 ±3.1）%, （33.6±7.2）%; （21.7±2.8）%, （34.2±6.9）%; （20.7±2.7）%, （32.8±6.9）%） （P〈0. 05）, and therewere no significant differences between ｜3D-CSS｜ and 3D-RSS of LAD, LCA and RCA in both groups （P〈0.05）. ROC analysis showed that the sensitivity, specificity and AUC of 3D-LSS （cut-off value： -17%） and 3D-ASS （cut-offvalue： -27%） for predicting positive CAG were 55.2%, 74.1%, 0. 702 and 61.2%, 72.2%, 0. 692, respectively. Thesensitivity, specificity and AUC of 3D-LSS （cut-off value： -17%） were 71. 9%, 81. 3% and 0. 817, and of 3D-ASS（cut-off value： -27%） were 76. 7%, 82. 9% and 0. 809 for predicting moderate to severe coronary artery stenosis,respectively. Conclusion 3D-LSS and 3D-ASS have the same value to predicting CAG, and have higher sensitivity andspecificity for predicting moderate to severe coronary artery stenosis.
出处
《中华实用诊断与治疗杂志》
2016年第9期904-907,共4页
Journal of Chinese Practical Diagnosis and Therapy
基金
陕西省卫计委科研项目(2014D17)
关键词
冠状动脉狭窄
左心室三维节段应变
冠状动脉造影
Coronary artery stenosis
left ventricular three-dimensional segmental longitudinal strain
coronaryangiography
