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三峡大学第一临床医学院宜昌市中心人民医院 超声科湖北,宜昌,443000
纸质出版日期:2022,
网络出版日期:2022-8-30,
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陈悦, 刘蓉, 董芝芝, 等. 二维斑点追踪技术评估合并右冠状动脉狭窄的冠心病患者右室功能的研究[J]. 临床超声医学杂志, 2022,24(8).
Evaluation of right ventricular function in patients with coronary artery disease with right coronary artery stenosis by Two-dimensional Speckle Tracking Echocardiography[J]. Journal of Clinical Ultrasound in Medicine, 2022,24(8).
陈悦, 刘蓉, 董芝芝, 等. 二维斑点追踪技术评估合并右冠状动脉狭窄的冠心病患者右室功能的研究[J]. 临床超声医学杂志, 2022,24(8). DOI:
Evaluation of right ventricular function in patients with coronary artery disease with right coronary artery stenosis by Two-dimensional Speckle Tracking Echocardiography[J]. Journal of Clinical Ultrasound in Medicine, 2022,24(8). DOI:
目的 探讨二维斑点追踪技术(two-dimensional speckle tracking echocardiography 2D-STE)在评估合并右冠状动脉狭窄的冠心病 (coronary artery disease
CAD)患者右室功能改变中的价值。方法 拟诊为冠心病的患者137例
进行常规超声心动图及组织多普勒超声检查。使用2D-STE测量右室游离壁整体峰值纵向应变(global longitudinal peak strain
GLS)、游离壁及室间隔侧基底段、中间段及心尖段收缩期纵向峰值应变(longitudinal peak systolic strain
ε)、右室收缩期峰值应变率(peak systolic strain rate
SRs)、舒张早期峰值应变率(peak early diastolic strain rate
SRe)及舒张晚期峰值应变率(peak late diastolic strain rate
SRa)。根据冠脉造影结果及是否合并右冠状动脉狭窄
分为对照组(A组
冠脉狭窄<50%)、冠心病不合并右冠状动脉狭窄组(B组)及冠心病合并右冠状动脉狭窄组(C组)。结果 三组间RVFAC、TAPSE、LVEF、SV、S’、Em、Am方面比较
差异无统计学意义(P>0.05)。三组间游离壁侧基底段ε、中间段ε、心尖段ε、游离壁GLS及SRs方面比较
差异均有统计学意义(P<0.05)。A组与B组在室间隔侧基底段ε及中间段ε比较差异无统计学意义(P>0.05)。与B组相比
C组的室间隔侧基底段ε及中间段ε减低(P<0.05)。三组间SRe、SRa及室间隔侧心尖段ε比较无统计学差异(P>0.05)。结论 合并右冠状动脉狭窄的冠心病患者右室收缩功能已发生亚临床改变
2D-STE可有效评估右室功能障碍
为临床冠心病患者右室功能的早期诊断及预后提供新的参考价值。
Objective To discuss the value of Two-dimensional Speckle Tracking Echocardiography (2D-STE) in evaluating the change of right ventricular function in patients with coronary artery disease (CAD) complicated with right coronary artery stenosis. Methods Conventional echocardiography and Tissue Doppler ultrasonography were performed in 137 patients suspected with CAD. 2D-STE was used to measure the global longitudinal peak strain (GLS) of the right ventricle
the longitudinal peak systolic strain (ε)
the peak systolic strain rate (SRs)
the peak early diastolic strain rate (SRe) and peak late diastolic strain rate (SRa) of the free wall and ventricular septal side for basal
mid
and apical segment. According to the results of coronary angiography and whether there was right coronary artery stenosis
they were divided into control group (group A
coronary artery stenosis < 50%)
CAD group without right coronary artery stenosis (group B) and CAD group with right coronary artery stenosis (group C). Results There were no significant differences in RVFAC
TAPSE
LVEF
SV
S’
Em and Am among the three groups (P > 0.05). There were significant differences in free wall basal
mid
apical ε
free wall GLS and SRs among the three groups (P < 0.05). There was no significant difference between group A and group B in the basal and mid segment ε of the ventricular septum (P > 0.05). Compared with group B
the basal and mid segment ε of ventricular septum was decreased in group C (P < 0.05). There were no significant differences in SRe
SRa and ventricular septal apical ε among the three groups (P > 0.05). Conclusions Right ventricular systolic function in CAD patients with right coronary artery stenosis has undergone subclinical changes. 2D-STE can effectively evaluate right ventricular dysfunction
providing new reference value for the early diagnosis and prognosis of right ventricular function in clinical CAD patients.
冠心病右冠状动脉狭窄斑点追踪技术右室功能
coronary artery diseaseright coronary artery stenosisspeckle tracking echocardiographyright ventricular function
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