Yang Zu-rong, Zhou Qi-chang, Lee Ling, Zou Ling, Zeng Shi, Tan Yi, Cao Dan-ming
Department of Ultrasonography, Central South University, Changsha, Hunan, People's Republic of China.
Echocardiography. 2012 Mar;29(3):340-5. doi: 10.1111/j.1540-8175.2011.01585.x. Epub 2011 Nov 8.
To assess the left ventricular (LV) longitudinal systolic function and asynchrony in patients with coronary atherosclerotic heart disease (CAD) by syngo velocity vector imaging (VVI).
Twenty-eight control subjects and 79 patients with CAD were examined, including 28 patients with myocardial infarction, 26 patients with coronary lumen stenosis <50%, and 25 patients with myocardial ischemia. According to the results of coronary arteriography and electrocardiogram (ECG), the myocardial segments of the LV of CAD patients were divided into four groups: ischemic, infarcted, nonischemic, and normal. Dynamic imaging was performed on all subjects. The systolic peak strain (Smax), systolic strain rate (SRmax), time to peak strain (PTs), and time to peak strain rate (PTsr) in every cardiac cycle were measured.
A total of 1,253 out of 1,712 (96.5%) segments were successfully analyzed with VVI. Smax and SRmax of the ischemic and infarcted segments were impaired in CAD patients. Optimal sensitivity and specificity were obtained with strain and strain rate cutoffs of -14.08% and -0.83 s(-1) , respectively, for detecting ischemic segments and -6.65% and -0.38 s(-1) , respectively, for detecting infarcted segments. The PTs and PTsr were significantly longer in the ischemic and infarcted segments compared to those of the control group.
Utilizing VVI, the longitudinal strain, strain rate, and peak time in CAD patients are easy to obtain and reproducible. Strain and strain rate cutoff values of abnormal myocardium are valuable for detecting ischemia and infarction. The PTs and PTsr values possibly estimate myocardium asynchrony in CAD patients.
通过西门子速度向量成像（VVI）评估冠状动脉粥样硬化性心脏病（CAD）患者的左心室（LV）纵向收缩功能及不同步性。
对28名对照者和79例CAD患者进行检查，其中包括28例心肌梗死患者、26例冠状动脉管腔狭窄<50%的患者以及25例心肌缺血患者。根据冠状动脉造影和心电图（ECG）结果，将CAD患者左心室的心肌节段分为四组：缺血组、梗死组、非缺血组和正常组。对所有受试者进行动态成像。测量每个心动周期中的收缩期峰值应变（Smax）、收缩期应变率（SRmax）、达到峰值应变的时间（PTs）以及达到峰值应变率的时间（PTsr）。
1712个节段中的1253个（96.5%）成功通过VVI分析。CAD患者缺血和梗死节段的Smax和SRmax受损。检测缺血节段时，应变和应变率的截断值分别为-14.08%和-0.83 s⁻¹，检测梗死节段时分别为-6.65%和-0.38 s⁻¹，此时获得最佳敏感性和特异性。与对照组相比，缺血和梗死节段的PTs和PTsr明显更长。
利用VVI可轻松获取CAD患者的纵向应变、应变率和峰值时间，且具有可重复性。异常心肌的应变和应变率截断值对检测缺血和梗死具有重要价值。PTs和PTsr值可能用于评估CAD患者心肌的不同步性。
