摘要
目的探讨实时心肌声学造影(RT-MCE)联合斑点追踪(STI)技术在冠状动脉粥样硬化性心脏病(以下简称冠心病)患者经皮冠状动脉介入(PCI)术后心肌功能及疗效评估中的应用价值。方法选取我院拟行PCI术的冠心病患者88例,均于术前、术后4周行RT-MCE和STI检查,获得RT-MCE参数和STI参数,包括心肌显影强度(A)、微泡破坏后再充盈的血流速度(β)、心肌血流量(A×β),以及纵向、径向、圆周应变及应变率(LS、RS、CS、LSr、RSr、CSr),比较术前、术后上述参数的差异。术后以冠状动脉造影为金标准,评估患者血管狭窄情况。绘制受试者工作特征(ROC)曲线分析RT-MCE参数及STI参数评估PCI术后疗效的效能。结果RT-MCE检查结果显示,冠心病患者术后A、β及A×β均较术前升高,差异均有统计学意义(均P<0.05)。STI检查结果显示,冠心病患者术后LS、CS均较术前降低,LSr、RS、RSr、CSr均升高,差异均有统计学意义(均P<0.05)。PCI术后冠状动脉造影显示血管正常61例,异常27例(中、重度狭窄分别为24例、3例)。ROC曲线分析显示,A、β、A×β、LS、RS、CS评估PCI术后疗效的曲线下面积分别为0.886、0.892、0.887、0.808、0.906及0.883。结论RT-MCE联合STI可有效评估PCI术前、术后左室心肌局部和整体功能,对PCI疗效评估具有重要价值。
Objective To explore the application value of real-time myocardial contrast-enhanced ultrasound(RTMCE)combined with speckle tracking(STI)in evaluating the myocardial function and therapeutic effect in patients with coronary heart disease after percutaneous coronary intervention(PCI).Methods A total of 88 patients with coronary heart disease and planned to underwent PCI were selected.All patients underwent RT-MCE and STI examinations before and 4 weeks after surgery,the RT-MCE and STI parameters were obtained,including myocardial imaging intensity(A),blood flow velocity after microbubble rupture and filling(β),myocardial blood flow(A×β),longitudinal,radial,circumferential strain and strain rate(LS,RS,CS,LSr,RSr,CSr). The differences of the above parameters before and after surgery were compared. Postoperative coronary angiography was used as the gold standard to evaluate the vascular stenosis of the patients. Receiver operating characteristic(ROC)curve was drawn to analyze the efficacy of RT-MCE parameters and STI parameters in evaluating the efficacy of PCI.Results The results of RT-MCE showed that the A,β and A×β in patients with coronary heart disease after surgery were higher than those before surgery,and the differences were statistically significant(all P<0.05).The results of STI results showed that the LS and CS in patients with coronary heart disease after surgery were lower than those before surgery,while the LSr,RS,RSr and CSr were higher than those before surgery,the differences were statistically significant(all P<0.05).After PCI,coronary angiography showed that 61 cases were normal and 27 cases were abnormal(24 cases of moderate stenosis,3 case of severe stenosis).ROC curve analysis showed that the AUC of A,β,A× β,LS,RS,and CS for evaluating the efficacy after PCI were 0.886,0.892,0.887,0.808,0.906,and 0.883,respectively.Conclusion RT-MCE combined with STI can effectively evaluate the local and global function of left ventricular myocardium before and after PCI,which is of great value in evaluating the efficacy of PCI.
作者
杨天芬
王安
梁琳
崔蕊
朱钰叶
YANG Tianfen;WANG An;LIANG Lin;CUI Rui;ZHU Yuye(Department of Cardiovascular Medicine,Xianyang First People’s Hospital,Shaanxi 712000,China)
出处
《临床超声医学杂志》
CSCD
2022年第12期946-949,共4页
Journal of Clinical Ultrasound in Medicine
关键词
超声心动描记术
心肌声学造影
斑点追踪
冠状动脉粥样硬化性心脏病
经皮冠状动脉介入术
心肌功能
疗效
Echocardiography
Myocardial contrast echocardiography
Speckle tracking
Coronary heart disease
Percutaneous coronary intervention
Myocardial function
Therapeutic effect
