左室压力-应变环评估冠心病患者经皮冠状动脉介入术前后心肌做功的临床研究

摘要 目的：应用左室压力-应变环（LV-PSL）评估冠心病患者经皮冠状动脉介入术（PCI）前后心肌做功的改变。方法：选取在中国人民解放军南部战区总医院行PCI治疗的冠心病患者40例为病例组，同期健康体检者42例为对照组，应用LV-PSL评估整体做功效率（GWE）、整体做功指数（GWI）、整体无用功（GWW）、整体有用功（GCW），比较对照组与病例组术前、术后1周、术后1个月各参数的差异，分析GWI、GCW、GWE、GWW与左室射血分数（LVEF）及左室整体纵向应变（GLS）的相关性。结果：与对照组相比，病例组术前、术后1周、术后1个月GWW升高，GCW、GWI、GWE降低（P<0.05）。与术前相比，术后1周GWI、GCW、GWE、GWW差异均无统计学意义（P>0.05）。与术前及术后1周相比，术后1个月GWW降低，GCW、GWI、GWE升高（P<0.05）。GWI、GCW、GWE、GWW与LVEF及GLS均显著相关（P<0.05）。结论：LV-PSL可定量评估冠心病患者PCI前后的心肌做功，为临床提供一种无创性评价PCI后心脏收缩功能的新方法。

Clinical Study of Left Ventricular Pressure-Strain Loop in Evaluating Myocardial Work in Patients with Coronary Heart Disease before and after Percutaneous Coronary Intervention

ABSTRACT Objective: To evaluate the changes of myocardial work in patients with coronary heart disease before and after percutaneous coronary intervention (PCI) by left ventricular pressure-strain loop (LV-PSL). Methods: 40 patients with coronary heart disease undergoing PCI in the Southern Theater General Hospital of the Chinese People''s Liberation Army were selected as the case group, and 42 healthy subjects during the same period were selected as the control group. LV-PSL was used to evaluate global work efficiency (GWE), global work index (GWI), global wasted work (GWW) and global constructive work (GCW), and the differences of parameters between the control group and the case group before operation, 1 week after operation and 1 month after operation were compared. The correlation of GWI, GCW, GWE, GWW and left ventricular ejection fraction(LVEF) and left ventricular global longitudinal strains (GLS) were analyzed. Results: Compared with the control group, GWW increased in the case group before operation, 1 week after operation and 1 month after operation, and GWI,GCW and GWE decreased(P<0.05). Compared with before operation, there were no significant differences in GWI, GCW, GWE and GWW at 1 week after operation (P>0.05). Compared with before operation and 1 week after operation, GWW decreased at 1 month after operation, and GCW, GWI and GWE increased(P<0.05). GWI, GCW, GWE, GWW were significantly correlated with LVEF and GLS (P<0.05). Conclusion: LV-PSL can quantitatively evaluate the myocardial work before and after PCI,providing a new non-invasive method for clinical evaluation of cardiac systolic function after PCI.