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目的:探讨超声心动图定量评价急性心肌梗死后患者双房的重构情况及形变能力。方法:选取我院确诊为急性心肌梗死患者(AMI组)61例及32例经心电、冠状动脉(冠脉)CT或造影检查排除冠心病的患者(对照组),心脏超声检查测得双房内径,最大、最小及收缩前容积(VFilaX、Vmin及Vp),计算双心房被动射血分数(LAPEF/RAPEF)及主动射血分数(LAAEF/RAAEF);留取动态图像进行二维斑点追踪脱机分析,获取双房备节段房壁左室收缩期的纵向峰值应变(LS)、应变率(SRs)、左室舒张早期峰值应变率(Sre)与左室舒张晚期峰值应变率(Sra)。并计算其平均峰值应变率(mSRs、mSRe、mSRa)。结果:与对照组比较,AMI组短期内双房重构无显著差异,双房主动射血分数显著增高(P<0.05),双房被动射血分数显著减低(P<0.05);mSRs、mSRe绝对值均减低(均P<0.05),mSRa绝对值增高(P<0.05)。结论:AMI早期双房均开始发生重构,但双房形变比容积变化更显著,二维斑点追踪应变成像能早期、敏感地定量评价AMI后双房功能的变化。
Objective: To investigate the echocardiographic quantitative evaluation of patients with acute myocardial infarction after remodeling and deformation of double room. Methods: 61 patients diagnosed as acute myocardial infarction (AMI group) and 32 patients with coronary heart disease (control group) undergoing coronary artery (coronary) CT or contrast-enhanced coronary angiography were enrolled in our hospital. (VFilaX, Vmin and Vp) were calculated, and the LAPEF / RAPEF and LAAEF / RAAEF were calculated. The dynamic images were taken for two-dimensional speckle tracking Off-line analysis was performed to obtain longitudinal peak strain (LS), strain rate (SRs), left ventricular diastolic peak (Sre) and left ventricular diastolic peak strain rate (Sra) ). And calculate the average peak strain rate (mSRs, mSRe, mSRa). Results: Compared with the control group, there was no significant difference in the short-term remodeling between two groups in the AMI group, and the spontaneous ejection fraction in the dual-chamber group was significantly increased (P <0.05) and the passive ejection fraction in the dual-chamber group was significantly reduced (P <0.05) Absolute value was decreased (all P <0.05), mSRa absolute value increased (P <0.05). CONCLUSIONS: Both early remodeling and early remodeling of AMI begin to occur. However, the change of specific volume of double-chamber deformation is more significant. Two-dimensional speckle tracking imaging can quantitatively evaluate the change of dual-function function in AMI patients in early stage and sensitively.