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目的:采用组织追踪成像(TTI)评价冠状动脉(冠脉)疾病患者的心肌收缩期及等容收缩期的运动。方法:85例因胸痛住院行冠脉造影的患者,术前1周接受常规超声心动图及TTI检查。根据冠脉造影结果分为对照组(50例,各支冠脉狭窄程度均<50%)和冠脉狭窄组(35例,至少1支冠脉狭窄程度≥75%)。结果:对照组患者的心肌收缩期运动呈梯度递减的抛物线样位移曲线,等容收缩期运动呈现为以正向为优势的双向位移曲线或单正向位移曲线,收缩期峰值位移(Dsys)从二尖瓣环处向心尖段递减,等容收缩期峰值位移(Divc)从基底段向心尖段递减。冠脉狭窄组Dsys的递变规律与对照组一致,但Dsys减小(P<0.05),多个节段的Divc值亦显著小于对照组(P<0.05),部分节段的Divc递变规律消失。此外,冠脉狭窄组患者中出现收缩后最大位移(Dmax)者较多。结论:冠脉狭窄时,Dsys及Divc均受影响,且多出现收缩后收缩现象。采用TTI定量评价左心室长轴运动可能有助于诊断心肌缺血。
OBJECTIVE: To evaluate myocardial systolic and isovolumic motor flow in patients with coronary artery disease (coronary artery disease) using tissue tracking imaging (TTI). Methods: Eighty-five patients underwent coronary angiography in hospital for chest pain. One week before operation, routine echocardiography and TTI were performed. According to coronary angiography results were divided into control group (50 cases, the degree of coronary stenosis were <50%) and coronary stenosis group (35 cases, at least 1 coronary stenosis ≥ 75%). Results: The myocardial systolic phase of the control group presented a gradient decreasing parabolic curve. The isotropic systolic phase presented a positive bidirectional displacement curve or a single positive displacement curve. The systolic peak displacement (Dsys) Mitral annulus decreased toward the apical segment, isovolumic peak systolic displacement (Divc) decreased from the basal segment to the apical segment. Dsys in coronary artery stenosis group was consistent with that in control group, but Dsys was decreased (P <0.05), and Divc values in multiple segments were significantly lower than those in control group (P <0.05) disappear. In addition, patients with coronary artery stenosis had a greater maximum posttranslational displacement (Dmax). Conclusions: Dsys and Divc are both affected by coronary stenosis, with contractions after contraction. Quantitative evaluation of left ventricular long-term exercise using TTI may be helpful in the diagnosis of myocardial ischemia.