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二维斑点追踪成像基于心脏运动的冠心病患者整体纵向应变及左心室缺血节段功能的定量评估。

Two-dimensional speckle tracking imaging cardiac motion-based quantitative evaluation of global longitudinal strain among patients with coronary Heart Disease and functions of left ventricular ischemic myocardial segment.

机构信息

Department of Cardiovascular, First People's Hospital of Linping District, Hangzhou, 311100, Zhejiang Province, China.

Department of Ultrasound, First People's Hospital of Linping District, Hangzhou, 311100, Zhejiang Province, China.

出版信息

Int J Cardiovasc Imaging. 2024 Feb;40(2):351-359. doi: 10.1007/s10554-023-02993-w. Epub 2023 Nov 13.

Abstract

To investigate two-dimensional speckle tracking imaging (2D-STI)-based quantitative evaluation of the influences of different levels of coronary artery stenosis on left ventricular functions and its clinical diagnostic values, 120 patients with coronary heart disease (CHD) were divided into control group (30 cases), mild stenosis group (30 cases), moderate stenosis group (30 cases), and severe stenosis group (30 cases) according to coronary angiography (CAG) results. They underwent routine ultrasound examination and 2D-STI examination. Receiver operating characteristic (ROC) curves were drawn to evaluate the sensitivity and specificity of different levels of coronary artery stenosis. Global longitudinal strain (GLS) of left ventricular myocardium among patients in moderate and severe stenosis groups remarkably declined (P < 0.05). Global radial strain (GRS) and global circular strain (GCS) among patients in severe stenosis group dramatically reduced (P < 0.05). ROC curves revealed that available GLS=-17.2 was the cut-off value for screening moderate coronary stenosis. The sensitivity, specificity, and area under the curve (AUC) amounted to 57.3%, 58.4%, and 0.573, respectively. GLS, GRS, and GCS could be used to screen severe coronary stenosis. When GLS=-16.5 was the cut-off value for screening severe coronary stenosis, sensitivity, specificity, and AUC amounted to 84.3%, 82.5%, and 0.893, respectively. With the aggravation of stenosis, left ventricular systolic function of CHD patients was impaired more significantly. 2D-STI technique could be adopted for the quantitative evaluation of left ventricular strain of patients with coronary stenosis and provided a new method for early clinical diagnosis of CHD.

摘要

为了探讨二维斑点追踪成像(2D-STI)对不同程度冠状动脉狭窄对左心室功能影响的定量评估及其临床诊断价值,根据冠状动脉造影(CAG)结果将 120 例冠心病(CHD)患者分为对照组(30 例)、轻度狭窄组(30 例)、中度狭窄组(30 例)和重度狭窄组(30 例)。他们接受了常规超声检查和 2D-STI 检查。绘制受试者工作特征(ROC)曲线评估不同程度冠状动脉狭窄的敏感性和特异性。中、重度狭窄组患者左心室心肌整体纵向应变(GLS)明显下降(P<0.05)。重度狭窄组患者的整体径向应变(GRS)和整体圆周应变(GCS)明显降低(P<0.05)。ROC 曲线显示,可利用的 GLS=-17.2 是筛选中度冠状动脉狭窄的截断值。其敏感性、特异性和曲线下面积(AUC)分别为 57.3%、58.4%和 0.573。GLS、GRS 和 GCS 可用于筛查严重的冠状动脉狭窄。当 GLS=-16.5 作为筛选严重冠状动脉狭窄的截断值时,敏感性、特异性和 AUC 分别为 84.3%、82.5%和 0.893。随着狭窄程度的加重,CHD 患者左心室收缩功能受损更明显。2D-STI 技术可用于定量评估冠状动脉狭窄患者的左心室应变,为 CHD 的早期临床诊断提供了一种新方法。

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