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目的采用二维斑点追踪技术(STE)评价急性心肌梗死(AMI)患者不同冠脉病变部位对左心房功能的影响。方法根据冠状动脉造影显示的犯罪血管将患者分为LAD组,LCX组及RCA组,其中LAD组31例,LCX组22例,RCA组26例。分别在PCI术后72h内行超声检查,检测左心房整体心肌收缩期纵向应变(LS)和应变率(LSR-s)、舒张早期应变率(LSR-e)及舒张晚期应变率(LSR-a)。PCI再通1个月后随访。结果 LCX组左心房LS及LSR-s较LAD组及RCA组明显减低(P<0.05)。三组左心室舒张功能、左心房容积及射血分数无显著差异。PCI再通1个月后,三组左心房功能无显著差异。结论 LCX组闭塞患者左心房功能较LAD组及RCA组闭塞患者更加减低,PCI再通后,左心房功能恢复。
Objective To evaluate the effect of different coronary lesions on left atrial function in patients with acute myocardial infarction (AMI) by two-dimensional speckle tracking (STE). Methods The patients were divided into LAD group, LCX group and RCA group according to the angiographic findings of coronary angiography. There were 31 cases in LAD group, 22 cases in LCX group and 26 cases in RCA group. The left ventricular total myocardial systolic longitudinal strain (LS) and strain rate (LSR-s), early diastolic strain rate (LSR-e) and late diastolic strain rate (LSR-a) . PCI recanalization after 1 month follow-up. Results Compared with LAD group and RCA group, LS and LSR-s of left atrium in LCX group decreased significantly (P <0.05). Three groups of left ventricular diastolic function, left atrium volume and ejection fraction no significant difference. One month after PCI recanalization, there was no significant difference in left atrial function in the three groups. Conclusions The left atrial function in patients with LCX occlusion is much lower than that in LAD and RCA patients. After recanalization, the left atrial function recovered.