左心室心肌做功效能评价冠状动脉慢血流患者左心室收缩及舒张功能

摘要

目的 采用二维斑点追踪技术(STE)检测冠状动脉慢血流(CSF)患者左心室心肌收缩及舒张做功效能(MSP/MDP).方法 收集经冠状动脉造影诊断为CSF患者50例(CSF组)和一般临床情况与之匹配的无CSF患者45例(对照组),采用STE检测左心室收缩期峰值整体纵向、径向和圆周应变及舒张早期应变率,计算左心室MSP和MDP,比较2组各参数的差异.结果 CSF组左心室收缩期峰值整体纵向、径向和圆周应变及舒张早期应变率、MSP和MDP均较对照组减低(P均＜0.05).CSF组冠状动脉平均血流帧数(TFC)与MDP呈负相关(r=-0.23,P=0.04);冠状动脉受累支数与MDP呈负相关(r=-0.31,P=0.03).不同冠状动脉受累支数与对照组左心室MDP整体比较差异有统计学意义(P均＜0.05),且受累2支、3支者MDP较对照组减低(P均＜0.05).结论 CSF患者左心室收缩及舒张功能均减低,且平均TFC越大,冠状动脉受累支数越多,左心室舒张功能减低越明显.利用左心室心肌做功效能可全面评价左心室收缩及舒张功能.%Objective To evaluate left ventricular systolic and diastolic functions of patients with coronary slow flow (CSF) according to left ventricular myocardial systolic/diastolic performances (MSP/MDP) by using two-dimensional speckle tracking echocardiography (STE).Methods Fifty patients with CSF diagnosed with coronary angiography (CSF group) and 45 patients without CSF (control group) underwent STE.Left ventricular systolic longitudinal,radial and circumferential peak strain and early-diastolic peak strain rate were measured,and left ventricular MSP and MDP were calculated,then the results were statistically analyzed between the 2 groups.Results Compared with control group,left ventricular systolic longitudinal,radial and circumferential peak strain and early-diastolic peak strain rate,MSP and MDP reduced in CSF group (all P＜0.05).The mean thrombolysis in myocardial infarction (TIMI) frame count (TFC) of coronary artery was negatively correlated with MDP (r=-0.23,P=0.04),and the number of affected coronary arteries was negatively correlated with MDP (r=-0.31,P=0.03).There was significant difference of MDP among patients with different numbers of affected coronary arteries and control group (all P＜0.05),and MDP in affected 2 and 3 coronary arteries patients were lower than those of the control group (all P＜ 0.05).Conclusion Left ventricular systolic and diastolic functions is impaired in patients with CSF.The mean TFC and the number of affected coronary arteries are negatively correlated with left ventricular diastolic function.Left ventricular MSP and MDP are comprehensive parameters in evaluating systolic and diastolic functions.