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实时三维超声心动图和二维斑点追踪成像在评估无心肌梗死的三支血管冠状动脉疾病患者左心房功能中的应用

Real-time three-dimensional echocardiography and two-dimensional speckle tracking imaging in the evaluation of left atrial function in patients with triple-vessel coronary artery disease without myocardial infarction.

作者信息

Yu Tingting, Cui Hongyan, Chang Wenxing, Li Ying, Cui Xiuxiu, Li Guangsen

机构信息

Department of Ultrasound, The Second Affiliated Hospital of Dalian Medical University, Dalian, China.

出版信息

J Clin Ultrasound. 2022 May;50(4):445-454. doi: 10.1002/jcu.23188. Epub 2022 Mar 8.

DOI:10.1002/jcu.23188
PMID:35261038
Abstract

OBJECTIVE

To evaluate left atrial function in patients with triple-vessel disease (TVD) without myocardial infarction by real-time three-dimensional echocardiography (RT-3DE) and two-dimensional speckle tracking imaging (2D-STE).

METHODS

Sixty patients with coronary artery disease (CAD) without myocardial infarction were classified into two groups in accordance with the coronary angiography results: group B (all triple-vessel stenosis ≥ 50% and < 75%) and group C (all triple-vessel stenosis ≥ 75%). Thirty healthy individuals were selected as group A. LA volume related parameters including left atrial maximum volume index (LAVImax), LA passive and active ejection fraction (LAPEF, LAAEF) and LA total ejection fraction (LATEF) were measured by RT-3DE. The global peak atrial longitudinal systolic strain (LASRs), early and late diastolic LA strain (LASRe and LASRa) rates were measured by 2D-STE.

RESULTS

We found statistically significant differences between 2D-STE and RT-3DE related parameters of these three groups. Furthermore, in groups B and C, N-terminal fragment brain natriuretic peptides (NT-pro-BNP) and left ventricular end-diastolic pressure (LVEDP) were found to be significantly correlated with LASRs and LASRa. And NT-pro-BNP had a moderate correlation with LVEDP.

CONCLUSIONS

2D-STE and RT-3DE can assess the LA function in patients with TVD without myocardial infarction. And LA strain values may provide additional information for predicting increased LVEDP and NT-pro-BNP.

摘要

目的

通过实时三维超声心动图(RT-3DE)和二维斑点追踪成像(2D-STE)评估无心肌梗死的三支血管病变(TVD)患者的左心房功能。

方法

60例无心肌梗死的冠心病(CAD)患者根据冠状动脉造影结果分为两组:B组(所有三支血管狭窄≥50%且<75%)和C组(所有三支血管狭窄≥75%)。选取30名健康个体作为A组。通过RT-3DE测量左心房容积相关参数,包括左心房最大容积指数(LAVImax)、左心房被动和主动射血分数(LAPEF、LAAEF)以及左心房总射血分数(LATEF)。通过2D-STE测量整体心房纵向收缩期峰值应变(LASRs)、舒张早期和晚期左心房应变(LASRe和LASRa)率。

结果

我们发现这三组的2D-STE和RT-3DE相关参数存在统计学显著差异。此外,在B组和C组中,发现N末端脑钠肽前体(NT-pro-BNP)和左心室舒张末期压力(LVEDP)与LASRs和LASRa显著相关。并且NT-pro-BNP与LVEDP具有中度相关性。

结论

2D-STE和RT-3DE可以评估无心肌梗死的TVD患者的左心房功能。并且左心房应变值可能为预测LVEDP和NT-pro-BNP升高提供额外信息。

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