心肌做功联合三维斑点追踪技术对冠状动脉病变的预测价值
Predictive value of myocardial performance combined with three-dimensional speckle tracking imaging to coronary artery lesions
黄伟强 1丛超 1王胜强 1刘秀1
作者信息
- 1. 264100 烟台,滨州医学院烟台附属医院心血管内科
- 折叠
摘要
目的 研究心肌做功联合三维斑点追踪技术(3D-STI)对冠状动脉(冠脉)狭窄程度的预测价值.方法 收集2022年1月至2022年6月于滨州医学院烟台附属医院心血管内科住院的符合标准的初诊为心绞痛患者121例.所有患者均行冠脉造影检查及在造影检查前24 h内接受非应力散斑追踪超声心动图检查.根据造影结果按是否存在冠脉管腔狭窄≥50%分为对照组(n=65)和病例组(n=56),比较两组心肌做功参数及三维斑点追踪技术的总体纵向峰值应变(GLPS)及收缩后收缩时间(Tpss)参数.结果 病例组整体做功效率(GWE)、整体做功指数(GWI)、整体有效做功(GCW)显著低于对照组,整体无效做功(GWW)高于对照组(P＜0.05).ROC曲线图结果示GCW(AUC=0.662,95%CI:0.582～0.773,P=0.001)、GWI(AUC=0.684,95%CI:0.609～0.793,P＜0.001)、GWE(AUC=0.790,95%CI:0.715～0.874,P＜0.001)、GWW(AUC=0.685,95%CI:0.608～0.796,P＜0.001).其中GWE预测冠脉狭窄最显著,GWE＜91.5%是诊断的临界值,敏感度为62.5%,特异度为83.1%.在分析左室收缩功能的17节段模型中,与对照组相比,病例组两腔心切面前壁中段的Tpss明显延长,差异有统计学差异(P＜0.05).结论 GWE是诊断不稳定型心绞痛患者冠脉病变的显著因子,三维斑点追踪指标中的Tpss对前降支狭窄具有诊断意义,上述两个指标联合可对左室功能进行客观评价并对病变血管进行初步判断.
Abstract
Objective To study the predictive value of myocardial performance(MP)combined with three-dimensional speckle tracking imaging(3D-STI)to the severity of coronary artery stenosis.Methods The patients with first-time diagnostic angina pectoris(AP,n=121)in accordance with diagnostic and internalized standard were chosen from Department of Cardiovascular Medicine in Yantai Affiliated Hospital of Binzhou Medical University from Jan.2022 to June 2022.All patients were given examination of coronary angiography(CAG)after receiving non-stress speckle tracking echocardiography 24 h before CAG.The patients were divided,according to CAG results,whether coronary lumen stenosis been≥50%or not,into control group(n=65)and case group(n=56).The parameters of MP and global longitudinal peak strain(GLPS)and post systolic time(Tpss)of 3D-STI were compared between 2 groups.Results The global work efficiency(GWE),global work index(GWI),and global effective work(GCW)were significantly lower,and global ineffective work(GWW)was significantly higher in case group than those in control group(P<0.05).The results of ROC curve analysis showed GCW with AUC=0.662(95%CI:0.582～0.773,P=0.001),GWI with AUC=0.684(95%CI:0.609～0.793,P<0.001),GWE with AUC=0.790(95%CI:0.715～0.874,P<0.001)and GWW with AUC=0.685(95%CI:0.608～0.796,P<0.001).Among them,GWE was the most significant in predicting coronary artery stenosis with GWE<91.5%being the diagnostic critical value,sensitivity 62.5%and specificity 83.1%.In 17-segment model for analyzing left ventricular systolic function,Tpss of anterior wall mid-segment of 2-chamber view extended significantly in case group compared with control group(P<0.05).Conclusion GWE is a significant factor for diagnosing coronary artery lesions in patients with unstable angina pectoris,and Tpss in 3D-STI has diagnostic significance to anterior descending branch stenosis.GWE combined with Tpss can objectively review left ventricular function and make preliminary judgments on the diseased vessels.
关键词
冠状动脉病变程度/心肌做功/三维斑点追踪Key words
Severity of coronary artery lesions/Myocardial performance/Three-dimensional speckle tracking imaging引用本文复制引用
出版年
2024
NETL
NSTL
维普
万方数据