Tanaka Hidekazu, Kawai Hiroya, Tatsumi Kazuhiro, Kataoka Toshiya, Onishi Tetsuari, Nose Takahisa, Mizoguchi Takahiro, Yokoyama Mitsuhiro
Division of Cardiovascular and Respiratory Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe, Japan.
J Am Soc Echocardiogr. 2006 Jun;19(6):756-62. doi: 10.1016/j.echo.2006.01.008.
This study investigated the effects of percutaneous coronary intervention (PCI) on global and regional left ventricular diastolic function, as assessed by strain rate (SR) imaging. In 27 patients with coronary artery disease, we performed echocardiography before and after PCI to obtain segmental peak systolic SR and peak early diastolic SR (E(SR)). PCI did not significantly change peak systolic SR in the ischemic (1.59 +/- 0.59-1.66 +/- 0.52/s) and nonischemic (1.64 +/- 0.59-1.61 +/- 0.53/s) segments. E(SR) in the ischemic segments was significantly smaller than that in the nonischemic segments at rest (1.82 +/- 0.71 vs 2.03 +/- 0.64/s, P < .01). PCI caused a significant increase in E(SR) from 1.82 +/- 0.71 to 2.29 +/- 0.92/s in the ischemic (P < .001), but not in the nonischemic, segments. The peak early diastolic transmitral flow velocities after PCI were improved in patients with greater extent of improvement of E(SR) in the ischemic segments. These findings suggest that the improvement in left ventricular early diastolic filling after PCI may be associated with the degree of improvement in impaired regional myocardial relaxation.
本研究通过应变率(SR)成像评估经皮冠状动脉介入治疗(PCI)对左心室整体和局部舒张功能的影响。对27例冠心病患者在PCI术前和术后进行超声心动图检查,以获取节段性峰值收缩期SR和峰值舒张早期SR(E(SR))。PCI并未使缺血节段(1.59±0.59 - 1.66±0.52/s)和非缺血节段(1.64±0.59 - 1.61±0.53/s)的峰值收缩期SR发生显著变化。静息时,缺血节段的E(SR)显著小于非缺血节段(1.82±0.71对2.03±0.64/s,P <.01)。PCI使缺血节段的E(SR)从1.82±0.71显著增加至2.29±0.92/s(P <.001),但非缺血节段未出现这种情况。在缺血节段E(SR)改善程度较大的患者中,PCI术后舒张早期二尖瓣血流峰值速度有所改善。这些发现表明,PCI术后左心室舒张早期充盈的改善可能与局部心肌舒张功能受损的改善程度有关。