中南大学学报(医学版)]CentSouthUniv(MedSci)DOI：10.11817/j.issn.l672-7347.2017.01.007www.csumed.org/xbwk/hleup/PDF/2017014I.pdf前壁急性心肌梗死经皮冠状动脉介入治疗术后左心室整体应变演变的临床价值杨祖荣I周启昌'，方臻飞2,曹丹鸣I周嘉炜\谭贤魄'(中南大学湘雅二医院1.超声科；2.心血管内科，长沙410011)［摘要］目的：应用速度向址成像(velocityvectorimaging,WI)技术探讨前壁急性ST段抬高型心肌梗死(ST-elevationmyocardialinfarction,STEMI)患者首次急诊经皮冠状动脉介入治疗(percutaneouscoronaryintervention.PCI)术后左心室整体纵向应变(globallongitudinalstrain,GLS)与整体环向应变(globalcircumferencialstrain,GCS)动态演变及其临床价值。方法：PCI组前壁STEMI患者S4例行首次急诊PCI术，对照组40例行冠状动脉造影术。采集术前与术后各时间点二维动态超声心动图，启动WI软件分析。同时抽取部分对象静脉血测定血浆N-末端脑钠肽原(N-terminalpro-B-typenatriureticpeptide,NT-proBNP)浓度。研究PCI组整体应变术后演变，并分析PClfH左心室整体纵向应变与血浆NT-proBNP的相关性。结果：PCI术后3dGLS显著升高(P<0.0S).术后6个月GLS与GCS均显著增高(P<0.05)°术后多时间点左室GLS与血浆NT-proBNP呈正相关(r=0.66,P<0.001)o急诊PCI术后3d左室GLS收缩期峰值-12.S0%可评价术后1及6个月血浆NT-proBNP改变。结论：左室整体纵向应变动态演变可为间接评价急性前壁STEMI急诊PCI术后心肌顿抑功能提供参考.术后3d左室整体纵向应变-12.S0%有望预测术后1.6个月心功能改善。［关键词］速度向量成像；应变；急性心肌梗死；经皮冠状动脉介入治疗；NT-proBNPClinicalvalueoftheevolutionofleftventricularglobalstraininanteriormyocardialinfarctionpatientstreatedwithemergencypercutaneouscoronaryinterventionYANGZurong1,ZHOUQichang1,FANGZhenfei2,CAODanming1,ZHOUJiawei',TANXiankui1(1.DepartmentofUltrasonography；2.DepartmentojCardiovascularMedicine,SecondXiangyaHospital,CentralSouthUniversity,Changsha410011,China)ABSTRACTObjective:Toinvestigatetheevolutionofleftventricularglobalstraininanteriormyocardialinfarctionpatientstreatedwithemergencypercutaneouscoronaryintervention(PCI).Methods:Atotalof54patientswithPCIwereenrolledasaPCIgroup.Fortyhealthysubjectswereenrolledasacontrolgroup.Dynamiccardiacimageswerecollected.Alloftheseimageswere收稿日期(Dateofreception):2015-08-31第一作者(Fir»tauthor):杨祖荣.Email：jocolin_1026@126.com通信作者(Correspondingauthor):周启昌，Email：hnzcq2013@163.com;方臻6.Email：zhenfeifang@sina.comanalyzedoff-linebyvelocityvectorimaging(WI)software.N-terminalpro-B-typenatriureticpeptide(NT-proBNP)wasmeasuredwithanelectrochemiluminescenceimmunoassaythroughtheElecsys1010/2010system.CorrelationanalysiswereundertakenbetweenWIandNT-proBNPlevelsinblood.Results:InPCIgroup,onlygloblelongitudinalstrain(GLS)wassignificantlyincreased3dayafteroperation(P<0.05).GLSandgloblecircumferencialstrain(GCS)weremarkedlyincreased6monthsafteroperation(P<0.05).InPCIgroup,leftventricularGLS1dto6monthsafterPCIshowspositivecorrelationwithIgNT-proBNPlevels(r=0.66,P<0.001).GLSvaluewas-12.50%atthe3rddayafteroperation,indicatingtheimprovmentofcardiacfunctioninthefirstandsixthmonthafterPCI.Conclusion:ThechangeofLeftventriculargloblelongitudinalsystolicfunctionafteremergencyPCImaybemoresensitivetotheimprovementofmyocardialstunningafterSTEMIreperfusion；GLSvalue(-12.50%)atthe3rddayafteroperationpredicttheimprovmentofcardiacfunctioninthefirstandsixthmonthsafterPCI.KEYWORDSvelocityvectorimaging；strain;acutemyocardialinfarction；percutaneouscoronaryintervention;NT-proBNP经皮冠状动脉介入治疗(percutaneouscoronaryintervent...