Li Ya-Jiao, Li Chen, Li Chun-Mei, Zhang Li, Bai Wen-Juan, Zhang Xiao-Ling, Tang Hong, Rao Li
Department of Cardiology, West China Hospital, Sichuan University, Chengdu 610041, China.
Sichuan Da Xue Xue Bao Yi Xue Ban. 2013 Jul;44(4):651-6.
To investigate the value of three-dimensional speckle tracking echocardiography (3DSTE) and the novel areas train (AS) in detecting wall motion abnormalities caused by coronary artery diseases.
Conventional and 3D echocardiography was done on forty-six patients suspected with coronary heart diseases, immediately before they received cardiac catheterization. Segmental wall-motion score (WMS) and WMS index (WMSI) were assessed on conventional two-dimensional (2D) images, and strain-derived parameters were analyzed by speckle tracking technique based on 3D images. The accuracy of echocardiographic parameters to assess the regional myocardial ischemia was tested against coronary angiography results using ROC curve analysis and linear regression.
Compared with controls, patients with severe coronary stenosis (> or = ;70% coronary stenosis) had lower left ventricular ejection fraction, higher WMSI and lower global strains. ROC curve analysis demonstrated that segmental WMS had relatively poor sensitivity for regional myocardial ischemia and infarction. The segmental strains measured using 3DSTE provided accurate assessment of the regional wall motion abnormalities. The segmental area strain > -25% yielded the best sensitivity and specificity for detecting the ischemic and infracted segments among all four strain parameters.
3DSTE provides a swift and accurate assessment of regional myocardial motion. The novel area strain derived by 3DSTE is an accurate and reproducible index for regional wall motion abnormality.
探讨三维斑点追踪超声心动图(3DSTE)及新的面积应变(AS)在检测冠状动脉疾病所致室壁运动异常中的价值。
对46例疑似冠心病患者在接受心导管检查前即刻进行常规及三维超声心动图检查。在常规二维(2D)图像上评估节段性室壁运动评分(WMS)及WMS指数(WMSI),并基于三维图像通过斑点追踪技术分析应变衍生参数。采用ROC曲线分析及线性回归,以冠状动脉造影结果为对照,检验超声心动图参数评估局部心肌缺血的准确性。
与对照组相比,严重冠状动脉狭窄(冠状动脉狭窄≥70%)患者的左心室射血分数较低,WMSI较高,整体应变较低。ROC曲线分析表明,节段性WMS对局部心肌缺血和梗死的敏感性相对较差。使用3DSTE测量的节段性应变可准确评估局部室壁运动异常。在所有四个应变参数中,节段性面积应变>-25%对检测缺血和梗死节段具有最佳的敏感性和特异性。
3DSTE可快速、准确地评估局部心肌运动。由3DSTE得出的新的面积应变是评估局部室壁运动异常的准确且可重复的指标。