Department of Radiology, Fourth Hospital of Harbin Medical University, 37 Yiyuan St, 150001 Harbin, Heilongjiang, China.
J Ultrasound Med. 2013 Nov;32(11):1951-6. doi: 10.7863/ultra.32.11.1951.
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.
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.
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.
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.
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。
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。
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。
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。