文章摘要
殷哲煜,王柏春,陈伟光,连 杰,娄 阳.三维斑点追踪技术联合左心腔声学造影评价CABG后左心室扭动[J].,2022,(23):4456-4460
三维斑点追踪技术联合左心腔声学造影评价CABG后左心室扭动
Three-dimensional Speckle Tracking Imaging Combined with Left Ventricular Opacification to Evaluate the Left Ventricular Twist after Coronary Artery Bypass Grafting
投稿时间:2022-04-23  修订日期:2022-05-18
DOI:10.13241/j.cnki.pmb.2022.23.011
中文关键词: 左心室扭动  超声心动图  三维斑点追踪技术  左心腔造影  冠状动脉搭桥术
英文关键词: Left ventricular twist  Echocardiography  Three-dimensional speckle tracking imaging(3D-STI)  Left ventricular opacification(LVO)  Coronary artery bypass grafting(CABG)
基金项目:哈尔滨医科大学附属第四医院科技创新人才项目(HYDSYKJCXRC202106)
作者单位E-mail
殷哲煜 哈尔滨医科大学附属第四医院 超声科 黑龙江 哈尔滨150001 yzy209@163.com 
王柏春 哈尔滨医科大学附属第四医院 心脏大血管外科 黑龙江 哈尔滨 150001  
陈伟光 哈尔滨医科大学附属第四医院 心脏大血管外科 黑龙江 哈尔滨 150001  
连 杰 哈尔滨医科大学附属第四医院 超声科 黑龙江 哈尔滨150001  
娄 阳 哈尔滨医科大学附属第四医院 心脏大血管外科 黑龙江 哈尔滨 150001  
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中文摘要:
      摘要 目的:应用三维斑点追踪技术联合左心腔声学造影评价冠状动脉搭桥术后左心室扭动的变化,探讨其评价治疗效果的临床应用价值。方法:(1)选择本院心脏外科接受择期冠状动脉搭桥术的患者30例,男19例,女11例,左室射血分数≥50%。排除急性及陈旧性心肌梗死病史、其他器质性心脏疾病。另外选择30名行冠状动脉造影或冠状动脉CT成像结果正常的人做为对照组,血生化、心电图检查结果正常。同时排除其它器质性疾病。(2)分别于搭桥术前1-3天、术后早期(7-15)天及术后3个月进行超声心动图检查,同时进行左心腔超声造影。开启4D模式,获取左室扭动参数,并进行手术前后对比分析。结果:左心腔造影可以提高设备自动描记的准确性。术前病例组的左室整体扭动幅度明显减低,与正常对照组相比差异具有显著性(P<0.05)。术后早期左室扭动角度略高于术前,仅中间段增高幅度与术前相比有显著性差异(P<0.05)。而手术后三个月左室扭动逐渐增强,接近正常对照组,与术后早期相比差异有显著性(P<0.05)。结论:三维斑点追踪显像联合左心腔造影可以准确检测冠状动脉搭桥手术前、后左心室扭动的变化。左室扭动可以敏感地反映术后左室心肌收缩功能的变化。
英文摘要:
      ABSTRACT Objective: To investigate the clinical application value in the evaluation of therapeutic effect by change of left ventricular twist in patients after coronary artery bypass grafting(CABG)we used 3D-speckle tracing imaging and left ventricular contrast echoc- ardiography. Methods: (1) A total of 30 patients (19 males and 11 females) who successfully underwent CABG with left ventricular ejection fraction ≥50% were selected from the cardiac surgery department of our hospital, excluding acute and old myocardial infarction history and other organic heart diseases. In addition, 30 subjects were selected as control group. They had normal by coronary angiography or coronary CT angiography, and blood biochemistry and electrocardiogram were normal. Other organic diseases were excluded.(2)Echocardiography was performed 1-3 days before bypass surgery, 7-15 days and 3 months after bypass surgery, while contrast-enhanced ultrasound was performed in the left heart cavity. Get left ventricular twist parameters when turning on 4D mode.Comparative analysis was made before and after operation. Comparative analysis was made before and after operation. Results: Left ventricular opacification can improve the accuracy of automatic recording.The twist amplitude of left ventricular is reduced in patients with coronary heart disease at before operation CABG, and difference was significant compared with the normal control group (P<0.05). The left ventricle twist was slightly higher than that before operation at the early postoperative period, only the difference of middle segment twist was significant compared with compared to the early postoperative period (P<0.05). The left ventriculart wist gradually continuous increase at 3 months after CABG compared to the early postoperative period (P<0.05). Conclusion: It can accurately detect the changes of left ventricular twist before and after coronary artery bypass surgery using 3D speckle tracking imaging combined with left ventricular opacification. Left ventricular twist can sensitively reflect the changes of myocardial systolic function of left ventricle after CABG.
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