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目的:初步探讨多普勒超声心动图定量组织速度成像(QTVI)及结合期前收缩后强化(PESP),评价左前降支(LAD)冠状动脉血运重建对相关室壁节段运动及心肌存活性的影响。方法:因LAD狭窄接受血运重建术的患者20例,于术前、术后1周测量LAD供血8个心肌节段在窦性心律时和PESP时的收缩期峰值速度(Vs)、舒张早期峰值速度(Ve)、舒张晚期峰值速度(Va)。并与46例正常人的相应参数相比较。结果:①冠心病组治疗前8个心肌节段中,7个节段的Vs、6个节段的Ve及3个节段的Va低于正常对照组(P<0.05～0.01),术后1周这些节段的3个参数较术前均有不同程度增加,其中4个节段的Vs,2个节段的Ve已恢复到正常水平(P>0.05);②冠心病组20例术前有84个节段Vs异常,术后1周30个节段恢复至正常;③冠心病组治疗前后PESP时各参数均较窦性心律时显著增大(P<0.05～0.01),但术后均无显著变化(P>0.05)。结论:QTVI能用于评价血运重建术疗效;PESP-QTVI评价术后1周心肌的室壁运动变化及心肌存活性的价值似不如QTVI。
OBJECTIVE: To investigate the quantitative tissue velocity imaging (QTVI) and precontraction enhancement (PESP) before and after Doppler echocardiography to evaluate the effects of left anterior descending coronary artery (LAD) coronary revascularization on related segments of wall motion and myocardial memory Effect of activity. Methods: Twenty patients underwent revascularization due to stenosis of LAD. The peak systolic velocity (Vs), peak systolic velocity (Vs) and peak systolic velocity (Vs) of 8 myocardial segments of LAD blood supply during sinus rhythm and PESP were measured before and 1 week after surgery. Peak velocity (Ve), Late diastolic peak velocity (Va). And compared with the corresponding parameters of 46 normal subjects. Results: ①In the coronary heart disease group, Vs in 7 segments, Ve in 6 segments and Va in 3 segments were lower than those in normal control group (P <0.05 ~ 0.01) The parameters of these three segments in one week increased at different degrees compared with that before operation. The Vs of two segments and Ve of two segments returned to the normal level (P> 0.05) 84 segments before Vs abnormalities, 30 weeks after 1 week returned to normal; ③ coronary heart disease before and after treatment of PESP parameters were significantly increased compared with sinus rhythm (P <0.05 ~ 0.01), but surgery After no significant change (P> 0.05). Conclusion: QTVI can be used to evaluate the efficacy of revascularization. PESP-QTVI is less effective than QTVI in assessing myocardial wall motion and myocardial viability one week after surgery.