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二维斑点追踪技术联合实时三维超声心动图在评估无心肌梗死的三支冠状动脉疾病患者右心房功能中的价值

Value of 2D speckle tracking technique combined with real-time 3-dimensional echocardiography in the evaluation of the right atrial function in patients with 3-branch coronary artery disease without myocardial infarction.

作者信息

Zhang Siran, Zhou Qiao, Li Xiya, Wang Yifan, Ma Le, Huang Dongmei, Li Guangsen

机构信息

Department of Ultrasound, the Second Hospital of Dalian Medical University, Dalian, Liaoning Province, China.

Department of Obstetrics and Gynecology Ultrasound, the Second Hospital of Dalian Medical University, Dalian, Liaoning Province, China.

出版信息

Medicine (Baltimore). 2024 May 3;103(18):e38058. doi: 10.1097/MD.0000000000038058.

Abstract

To evaluate the right atrial function in patients with 3-branch coronary artery disease (TBCAD) without myocardial infarction by 2D speckle tracking echocardiography (2D-STE) combined with real-time 3-dimensional echocardiography (RT-3DE). Fifty-six patients admitted to our hospital without myocardial infarction with TBCAD were selected. We divided them into 2 groups according to the coronary angiography results: 28 patients in group B (the rate of stenosis is 50% ~< 75%); 28 patients in group C (the rate of stenosis is ≥75%); in addition, 30 healthy volunteers were screened as group A. All subjects underwent RT-3DE to obtain the right atrial volume (RAVmax, RAVmin, and RAVp), and then we calculated the right atrial passive and active ejection fraction (RAPEF, RAAEF), and maximum volume index (RAVImax). In addition, to measure the strain rates (RASRs, RASRe, RASRa) of the right atrium during systole, early diastole, and late diastole, 2D-STE was applied. Correlations between the 2D-STE parameters and the results of N-terminal pro-brain natriuretic peptide (NT-proBNP) and Gensini scores were analyzed by Pearson linear analysis. Compared with group A, RAPEF and RASRe were reduced, while RAAEF and RASRa were elevated in group B (P < .05). RAPEF, RASRs, RASRe, and RASRa were decreased compared with groups A and B, while RAVmax, RAVmin, RAVp, RAVImax, and RAAEF were increased in group C (P < .05). There was a significant correlation between 2D-STE parameters and the results of NT-proBNP and Gensini scores (P < .05). The storage, conduit, and pump functions of the right atrium are reduced in patients with 3-branch coronary artery disease without myocardial infarction; 2D-STE combined with RT-3DE is valuable in the evaluation of the right atrium in patients with coronary artery disease.

摘要

采用二维斑点追踪超声心动图(2D-STE)联合实时三维超声心动图(RT-3DE)评估无心肌梗死的三支冠状动脉疾病(TBCAD)患者的右心房功能。选取我院收治的56例无心肌梗死的TBCAD患者。根据冠状动脉造影结果将其分为2组:B组28例(狭窄率为50%~<75%);C组28例(狭窄率≥75%);此外,筛选30名健康志愿者作为A组。所有受试者均接受RT-3DE以获取右心房容积(RAVmax、RAVmin和RAVp),然后计算右心房被动和主动射血分数(RAPEF、RAAEF)以及最大容积指数(RAVImax)。此外,应用2D-STE测量右心房在收缩期、舒张早期和舒张晚期的应变率(RASRs、RASRe、RASRa)。采用Pearson线性分析分析2D-STE参数与N末端脑钠肽前体(NT-proBNP)结果及Gensini评分之间的相关性。与A组相比,B组的RAPEF和RASRe降低,而RAAEF和RASRa升高(P<0.05)。与A组和B组相比,C组的RAPEF、RASRs、RASRe和RASRa降低,而RAVmax、RAVmin、RAVp、RAVImax和RAAEF升高(P<0.05)。2D-STE参数与NT-proBNP结果及Gensini评分之间存在显著相关性(P<0.05)。无心肌梗死的三支冠状动脉疾病患者右心房的储存、管道和泵功能降低;2D-STE联合RT-3DE在评估冠心病患者右心房方面具有重要价值。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7132/11062688/4b0959bdfbf9/medi-103-e38058-g001.jpg

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