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斑点追踪成像监测冠状动脉旁路移植术后心肌功能。

Speckle-tracking imaging to monitor myocardial function after coronary artery bypass graft surgery.

机构信息

Department of Radiology, Fourth Hospital of Harbin Medical University, 37 Yiyuan St, 150001 Harbin, Heilongjiang, China.

出版信息

J Ultrasound Med. 2013 Nov;32(11):1951-6. doi: 10.7863/ultra.32.11.1951.

Abstract

OBJECTIVES

The purpose of this study was to investigate the changes in myocardial function in patients after coronary artery bypass graft (CABG) surgery using longitudinal and circumferential strain on speckle-tracking imaging.

METHODS

A total of 145 patients who successfully underwent CABG surgery with a left ventricular ejection fraction (LVEF) of 50% or greater were enrolled in this study. Patients were classified into 4 groups based on age: group 1 (33-59 years), group 2 (60-64 years), group 3 (65-69 years), and group 4 (70-79 years). Routine echocardiography and longitudinal and circumferential strain measurements on speckle-tracking imaging were performed 1 week before and 1, 3, and 6 months after the CABG.

RESULTS

In all groups, longitudinal strain increased significantly at 3 and 6 months after CABG therapy compared to baseline (P < .05). A significant increase in circumferential strain was found 1 month after the CABG in groups 1, 2, and 3, and a continuous increase in the parameter was observed in all groups 3 months after therapy (P < .05). However, the LVEF, left ventricular end-diastolic dimension, and stroke volume measured by routine echocardiography were not significantly changed after successful CABG treatment in all groups during 6 months of follow-up.

CONCLUSIONS

Based on the results of our study in all age groups, speckle-tracking imaging parameters are more effective than the LVEF, left ventricular end-diastolic dimension, and stroke volume for monitoring improvement in myocardial function after CABG surgery.

摘要

目的

本研究旨在通过斑点追踪成像技术研究左心室射血分数(LVEF)≥50%的冠状动脉旁路移植(CABG)术后患者心肌功能的变化。

方法

共纳入 145 例成功接受 CABG 手术且 LVEF≥50%的患者。根据年龄将患者分为 4 组:组 1(33-59 岁)、组 2(60-64 岁)、组 3(65-69 岁)和组 4(70-79 岁)。所有患者分别在 CABG 术前 1 周及术后 1、3、6 个月进行常规超声心动图和斑点追踪成像的纵向和环向应变测量。

结果

所有组在 CABG 治疗后 3 和 6 个月时,纵向应变均较基线显著增加(P<0.05)。在组 1、2 和 3,CABG 后 1 个月时环向应变显著增加,所有组在治疗后 3 个月时该参数持续增加(P<0.05)。然而,在所有组的 6 个月随访中,常规超声心动图测量的 LVEF、左心室舒张末期内径和每搏量在成功的 CABG 治疗后并未发生显著变化。

结论

基于我们在所有年龄组的研究结果,斑点追踪成像参数比 LVEF、左心室舒张末期内径和每搏量更能有效监测 CABG 术后心肌功能的改善。

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