三维斑点追踪成像及DDIAS诊断中度和重度冠状动脉狭窄的研究

doi:10.7517/issn.1674-0475.221017

摘要/Abstract

摘要： 本研究考察三维斑点追踪成像（3D-STI）技术及DNA损伤诱导凋亡抑制因子（DDIAS）诊断中度和重度冠状动脉狭窄的价值。对112例冠心病患者进行3D-STI检查，并于24 h内经冠状动脉造影（CAG）证实为冠状动脉狭窄。根据CAG结果，按狭窄百分比将患者分为轻微、轻度、中度和重度组。同时选择30例健康体检者作为对照组。通过酶联免疫吸附测定（ELISA）法检测冠心病患者和健康体检者的血清DDIAS。结果显示，随着狭窄程度的升高，3D-GAS、3D-GLS、3D-GCS和3D-GRS均逐渐升高（P<0.05）。冠心病患者的血清DDIAS水平高于健康体检者，且随着狭窄程度的升高，血清DDIAS水平逐渐升高（P<0.05）。3D-GAS诊断中度和重度冠状动脉狭窄的ROC曲线下面积（AUC）（0.846）和敏感性（98.28%）较高，但特异性（57.41%）较低。血清DDIAS诊断中度和重度冠状动脉狭窄的AUC、敏感性和特异性依次为0.910、84.48%和90.74%。3D-STI参数联合血清DDIAS诊断中度和重度冠状动脉狭窄的AUC、敏感性和特异性依次为0.979、96.55%和96.30%。3D-STI参数联合血清DDIAS诊断中度和重度冠状动脉狭窄的AUC和特异性高于单独诊断，敏感性仅次于3D-GAS单独诊断，有助于对冠状动脉狭窄的准确诊断。

关键词: 三维斑点追踪成像, 冠状动脉狭窄, DNA损伤诱导凋亡抑制因子, 三维整体面积应变

Abstract: This study investigated the value of three-dimensional speckle tracking imaging (3D-STI) and DNA damage-induced apoptosis suppressor (DDIAS) in the diagnosis of moderate and severe coronary artery stenosis. 112 patients with suspected coronary heart disease were examined by 3D-STI, and coronary artery stenosis was confirmed by coronary angiography (CAG) within 24 hours. Based on CAG results, the patients were divided into slight, mild, moderate, and severe groups by percentage of stenosis. At the same time, 30 healthy subjects were selected as the control group. Serum DDIAS in patients with coronary heart disease and healthy subjects were detected by enzyme-linked immunosorbent assay (ELISA). The results showed that with the increase of stenosis degree, 3D-GAS, 3D-GLS, 3D-GCS and 3D-GRS all increased gradually (P<0.05). The level of serum DDIAS in patients with coronary heart disease was higher than that in healthy subjects, and the level of serum DDIAS gradually increased with the increase of stenosis degree (P<0.05). The area under the ROC curve (AUC) (0.846) and sensitivity (98.28%) of 3D-GAS for diagnosing moderate and severe coronary artery stenosis were higher, but the specificity was lower (57.41%). The AUC, sensitivity and specificity of serum DDIAS in the diagnosis of moderate and severe coronary artery stenosis were 0.910, 84.48% and 90.74%, respectively. The AUC, sensitivity and specificity of 3D-STI parameters combined with serum DDIAS in the diagnosis of moderate and severe coronary artery stenosis were 0.979, 96.55% and 96.30%, respectively. The AUC and specificity of 3D-STI parameters combined with serum DDIAS in the diagnosis of moderate and severe coronary artery stenosis were higher than those of single diagnosis, and the sensitivity was second only to that of 3D-GAS alone. It is helpful for the accurate diagnosis of coronary artery stenosis.

Key words: three-dimensional speckle tracking imaging, coronary stenosis, DNA damage-induced apoptosis inhibitor, three-dimensional global area strain

凌静霞, 王磊, 杜欣. 三维斑点追踪成像及DDIAS诊断中度和重度冠状动脉狭窄的研究[J]. 影像科学与光化学, 2023, 41(1): 102-108.

LING Jingxia, WANG Lei, DU Xin. Study of Three-dimensional Speckle Tracking Imaging and DDIAS in the Diagnosis of Moderate and Severe Coronary Artery Stenosis[J]. IMAGING SCIENCE AND PHOTOCHEMISTRY, 2023, 41(1): 102-108.

参考文献

[1] Bai M F, Wang X. Risk factors associated with coronary heart disease in women:A systematic review[J]. Herz, 2020, 45(Suppl 1):52-57.
[2] Tian Y, Deng P J, Li B, et al. Treatment models of cardiac rehabilitation in patients with coronary heart disease and related factors affecting patient compliance[J]. Reviews in Cardiovascular Medicine, 2019, 20(1):27-33.
[3] Fadnes S, Nyrnes S A, Torp H, et al. Shunt flow evaluation in congenital heart disease based on two-dimensional speckle tracking[J]. Ultrasound in Medicine & Biology, 2014, 40(10):2379-2391.
[4] Weng Y H, Liu Y, Deng Y, et al. Rapidly and accurately detecting significant coronary artery stenosis in patients with suspected stable coronary artery disease and normal segmental wall motion by speckle tracking automated functional imaging[J]. Ultrasound in Medicine & Biology, 2021, 47(3):546-555.
[5] 陈文娟, 朱文晖, 王艳. MCE与2D-STI评价不同冠状动脉狭窄程度患者的心肌灌注水平与收缩功能[J]. 中南大学学报(医学版), 2020, 45(1):35-39.
[6] Han X, Zhu W, Chen W. Evaluation of myocardial perfusion and systolic function in patients with coronary heart disease by myocardial contrast echocardiography and 2-dimensional speckle tracking imaging[J]. Zhong Nan Da Xue Xue Bao Yi Xue Ban, 2021, 46(11):1233-1240.
[7] Saito K, Okura H, Watanabe N, et al. Comprehensive evaluation of left ventricular strain using speckle tracking echocardiography in normal adults:Comparison of three-dimensional and two-dimensional approaches[J]. Journal of the American Society of Echocardiography, 2009, 22(9):1025-1030.
[8] Sun Y J, Wang F, Zhang R S, et al. Incremental value of resting three-dimensional speckle-tracking echocardiography in detecting coronary artery disease[J]. Experimental and Therapeutic Medicine, 2015, 9(6):2043-2046.
[9] Tao Z W, Ma X W, Liu N N, et al. Evaluation on the impact of spontaneous reperfusion on cardiac muscle of acute myocardial infarction by three-dimensional speckle tracking imaging[J]. European Review for Medical and Pharmacological Sciences, 2017, 21(23):5445-5450.
[10] Wang Y, Hu H F, Liu H L, et al. Using ultrasound three-dimensional speckle tracking technology to explore the role of SIRT1 in ventricular remodeling after myocardial infarction[J]. European Review for Medical and Pharmacological Sciences, 2020, 24(20):10632-10645.
[11] Altman M, Bergerot C, Aussoleil A, et al. Assessment of left ventricular systolic function by deformation imaging derived from speckle tracking:A comparison between 2D and 3D echo modalities[J]. European Heart Journal-Cardiovascular Imaging, 2013, 15(3):316-323.
[12] 陈莹, 刘昕, 郭淑芹. 实时三维斑点追踪成像技术评价冠状动脉狭窄患者左心室整体及局部心肌收缩功能[J]. 中华超声影像学杂志, 2014, 23(11):934-938.
[13] 汪彩英, 周青, 张才智, 等. 三维及二维斑点追踪技术检测冠状动脉狭窄临床价值的对比研究[J]. 中华超声影像学杂志, 2013, 22(8):654-658.
[14] 李丹, 刘梅, 牛海燕, 等. 三维斑点追踪成像评价冠脉不同程度狭窄心肌整体应变参数变化[J]. 中国循证心血管医学杂志, 2016, 8(4):421-424.
[15] Bhat M A, Gandhi G. Elevated oxidative DNA damage in patients with coronary artery disease and its association with oxidative stress biomarkers[J]. Acta Cardiologica, 2019, 74(2):153-160.
[16] Im J Y, Lee K W, Won K J, et al. NFATc1 regulates the transcription of DNA damage-induced apoptosis suppressor[J]. Data in Brief, 2015, 5:975-980.
[17] Im J Y, Lee K W, Won K J, et al. DNA damage-induced apoptosis suppressor (DDIAS), a novel target of NFATc1, is associated with cisplatin resistance in lung cancer[J]. Biochimica et Biophysica Acta:BBA-Molecular Cell Research, 2016, 1863(1):40-49.
[18] Nakaya N, Hemish J, Krasnov P, et al. Noxin, a novel stress-induced gene involved in cell cycle and apoptosis[J]. Molecular and Cellular Biology, 2007, 27(15):5430-5444.
[19] Li L, Zhang P Y, Ran H, et al. Evaluation of left ventricular myocardial mechanics by three-dimensional speckle tracking echocardiography in the patients with different graded coronary artery stenosis[J]. The International Journal of Cardiovascular Imaging, 2017, 33(10):1513-1520.
[20] Hoit B D. Strain and strain rate echocardiography and coronary artery disease[J]. Circulation Cardiovascular Imaging, 2011, 4(2):179-190.
[21] Rostamzadeh A, Shojaeifard M, Rezaei Y, et al. Diagnostic accuracy of myocardial deformation indices for detecting high risk coronary artery disease in patients without regional wall motion abnormality[J]. International Journal of Clinical and Experimental Medicine, 2015, 8(6):9412-9420.
[22] Stanton T, Leano R, Marwick T H. Prediction of all-cause mortality from global longitudinal speckle strain:comparison with ejection fraction and wall motion scoring[J]. Circulation Cardiovascular Imaging, 2009, 2(5):356-364.
[23] Zhai Z J, Qin W J, Wang Z, et al. Changes in left ventricular function induced by carboplatin combined with paclitaxel in patients with ovarian cancer identified using three-dimensional spot tracking imaging technology[J]. Journal of Clinical Ultrasound, 2021, 49(4):378-384.
[24] Chang D, Wang F, Zhao Y S, et al. Evaluation of oxidative stress in colorectal cancer patients[J]. Biomedical and Environmental Sciences, 2008, 21(4):286-289.
[25] Deavall D G, Martin E A, Horner J M, et al. Drug-induced oxidative stress and toxicity[J]. Journal of Toxicology, 2012, 2012:645460.
[26] Martinet W, Knaapen M W M, De Meyer G R Y, et al. Elevated levels of oxidative DNA damage and DNA repair enzymes in human atherosclerotic plaques[J]. Circulation, 2002, 106(8):927-932.
[27] Bhat M A, Gandhi G. Assessment of DNA damage in leukocytes of patients with coronary artery disease by comet assay[J]. International Heart Journal, 2017, 58(2):271-274.
[28] Mahmoudi M, Mercer J, Bennett M. DNA damage and repair in atherosclerosis[J]. Cardiovascular Research, 2006, 71(2):259-268.
[29] Brunette G J, Jamalruddin M A, Baldock R A, et al. Evolution-based screening enables genome-wide prioritization and discovery of DNA repair genes[J]. Proceedings of the National Academy of Sciences of the United States of America, 2019, 116(39):19593-19599.
[30] Im J Y, Kim B K, Lee J Y, et al. DDIAS suppresses TRAIL-mediated apoptosis by inhibiting DISC formation and destabilizing caspase-8 in cancer cells[J]. Oncogene, 2018, 37(9):1251-1262.