文章摘要

文章信息/Info

Title:: Preliminary evaluation of left ventricular strain and torsion in clinical cardiac function classification in coronary artery disease

作者:: 王佳玲¹; 郑逸²; 阮海东²; 王良玉²; (1.汕头市第二人民医院超声科，广东汕头 515031；
2.中山大学附属汕头医院超声科，广东汕头 515031)

Author(s):: WANG Jia-ling¹; ZHANG Yi²; RUAN Hai-dong²; WANG Liang-yu²; (1.Department of Ultrasound, Shantou Second People’s Hospital, Shantou 515031, Guangdong, China；
2.Department of Ultrasound, Affiliated Shantou Hospital, Sun Yat-sen University, Shantou 515031, Guangdong, China)

关键词:: 冠状动脉疾病; 临床心功能分级; 应变; 扭转角度

Keywords:: coronary artery disease; New York Heart Association (NYHA); strain; torsion angle

分类号:: R541.4；R445.1

DOI:: -

文献标识码:: A

摘要:: 目的应用二维超声斑点追踪技术（2D-STI）检测冠心病心肌应变和扭转改变与临床心功能分级进行比较，初步评价心肌应变及扭转定量判断冠心病临床心功能的价值。方法将56例冠心病患者分为临床心功能接近正常或正常组（30例）及心功能异常（26例），比较受检者临床心功能积分（NYHA-AP）、左室射血分数(LVEF)、左室心肌整体径向应变（GRS）、纵向应变（GLS）、左室心肌收缩期心肌扭转角度（TA）。结果两组比较：GLS、GRS、TA减低(P<0.05)；心功能正常组GLS、GRS、TA与NYHA-AP及LVEF相关性不大，LVEF与NYHA-AP也相关性不大，而心功能异常组呈相关关系；以GLS-15.05%截断点判定患者心功能符合临床NYHA分级Ⅰ~Ⅱ级，灵敏度为88%、特异度为70%。结论 2D-STI技术检测心肌应变及扭转与临床心功能分级相关，有较好的灵敏度和特异度。

Abstract:: AIM To study left ventricular myocardial strain and torsion using 2D speckle tracking technology (2D-STI) and to explore the value of myocardial strain and torsion in quantitative assessment of the New York Heart Association (classification) accumulated points (NYHA-AP) in coronary artery disease (CAD). METHODS Fifty-six patients with CAD were divided into normal clinical heart function group (group A, n=30) and dysfunctional clinical cardiac group (group B, n=26). Thirty subjects without CAD were recruited as normal control group (group C). Left ventricular ejection fraction (LVEF), left ventricular myocardial global longitudinal strain (GLS), global radial strain (GRS) and left ventricular myocardial systolic torsion angle (TA) were detected and compared between groups. RESULTS LVEF, GLS, GRS and TA in CAD group were lower (P<0.05) than those in the control group. There was no correlation between LVEF and GLS in group A (P>0.05), GLS and LVEF were positively correlated in group B, and GLS, GRS and TA in group B were lower than those in group A (P<0.05). LVEF had no correlation with NYHA-AP in group A but were positively correlated in Group B. Sensitivity and specificity of the cut-off point of GLS-15.05% for determining NYHA class I-II grade were, respectively, 88.45% and 70%. CONCLUSION 2D-STI has unique advantages in evaluating regional myocardial function. Clinical cardiac function classification and LVEF are not synchronized and myocardial strain and torsion are correlated with clinical cardiac function. Regional myocardial function variation develops simultaneously with clinical cardiac function. Myocardial strain and torsion decreases even if NYHA is still good or to a lesser degree. Decreased myocardial strain and torsion indicate the development of heart dysfunction.

参考文献/References

[1]张子彬,Tsung O,张玉传,等.充血性心力衰竭学[M].北京:科学文献出版社,2002:211-212.
[2]储彦芬,唐海沁，汪太平,等.二维斑点追踪技术评价冠心病患者左室整体收缩功能及其与冠状动脉病变程度的关系[J].安徽医科大学学报,2015,2(1):83-86.
[3]欧阳斯华,王良玉, 张帆，等.超声斑点追踪技术检测冠心病患者左心室生物力学参数评估冠状动脉狭窄的初步研究[J]. 岭南心血管病杂志,2015,21(4):493-496.
[4]刘艳午,黄红梅,曹礼庭,等.二维斑点追踪技术评价冠心病患者缺血心肌的应变、旋转和扭转的研究[J].中国超声医学杂志,2014,30(7):609-613.
[5]Leitman M,Lysyansky P,Sidenko S,et al.Two-dimensional strain-a novel software for real-time quantitative echocardiographic assessment of myocardial function[J].J Am Soc Echocardiogr,2004,17(10):1021-1019.
[6]王洲,李健,任永凤,等.二维应变超声心动图的研究进展及临床应用[J].中国医学影像技术,2008,24(6):959-961.
[7]王良玉,欧阳斯华,张帆,等.超声斑点追踪技术评估冠心病心功能变化对冠状动脉狭窄的预测价值[J].中国循环杂志,2014,6 (10):167-178.
[8]Langeland S,Wouters PF,Claus P,et al.Experimental assessment of a new research tool for the estimation of two-dimensional myocardial strain[J].Ultrasound Med Biol,2006,32(10):1509-1513.
[9]张烨,李治安,杨娅,等.二维应变超声心动图定量评价左心室整体和局部心肌应变的价值[J].中华超声影像学杂志,2007,16(7):564-565. （收稿日期：2016-02-26；接受日期：2016-04-11）

我们的网站为什么显示成这样？

左室应变及扭转评价冠心病临床心功能的初步研究(PDF)

《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

文章信息/Info

参考文献/References

备注/Memo

常用功能

导航/Navigate

工具/Tools

统计/Statistics