定量组织速度成像测量二尖瓣环运动速度评价肥厚型心肌病患者左室舒张功能  

Assessment of the left ventricular diastolic function by quantitative tissue velocity imaging in patients with hypertrophic cardiomyopathy

作　　者：李秀兰[1] 邓又斌[1] 常青[1] 杨好意[1] 黎春雷[1] 潘敏[1] 

机构地区：[1]华中科技大学同济医学院附属同济医院超声影像科,武汉430030

出　　处：《临床心血管病杂志》2004年第7期429-431,共3页Journal of Clinical Cardiology

摘　　要：目的 :应用定量组织速度成像 (QTVI)测量二尖瓣环运动速度评价肥厚型心肌病 (HCM )患者左室舒张功能。方法 :QTVI测量 31例HCM患者 (HCM组 )和 2 0例正常人 (对照组 )二尖瓣环 6个节段 (后间隔和侧壁、前间隔和后壁、前壁和下壁 )舒张早期峰值速度 (Ve)、左房收缩期峰值速度 (Va) ,计算平均Ve、Va和Ve/Va比值。多普勒超声心动图测量二尖瓣口血流快速充盈速度E峰、左房收缩充盈速度A峰 ,计算E/A值和E与平均Ve的比值 (E/Ve)。结果 :HCM患者平均Ve和Ve/Va较对照组明显减低 [(Ve:(3.6 4± 1.4 1)cm/s∶(8.2 1±1.6 9)cm/s,P <0 .0 1;Ve/Va:(0 .92± 0 .5 1)∶(1.5 7± 0 .5 0 ) ,P <0 .0 1;E和E/A较对照组减低 [E :(74 .73±2 6 .5 5 )cm/s∶(84 .0 0± 14 .5 7)cm/s ,P =0 .14 2 ;E/A :(1.12± 0 .4 9)∶(1.6 8± 0 .4 1) ,P <0 .0 1;E/Ve较对照组明显增高 [(2 3.0 3± 7.73)∶(10 .5 3± 2 .6 7) ,P <0 .0 1]。E/A <1者 14例 (4 5 .2 % ) ,Ve/Va <1者 2 0例 (6 4 .5 % ) ;E/A >1的HCM患者其Ve和Ve/Va亦较对照组明显减低 ,E/Ve明显增高。结论 :HCM患者二尖瓣口多普勒血流信号E、A受前负荷和左房收缩性等因素的影响 ,而QTVI测量二尖瓣环运动速度能准确评价HCM患者左室舒张功能。Objective:To assess the left ventricular diastolic function in patients with hypertrophic cardiomyopathy(HCM) using mitral annulus velocity determined by quantitative tissue velocity imaging (QTVI).Method:Mitral annulus velocity from posteroseptal, lateral, anteroseptal, posterior, anterior and inferior segments during early diastole (Ve), atrial contraction (Va) were measured by QTVI in 31 HCM patients and 20 healthy subjects, and mean Ve, Va and Ve/Va were calculated. Transmitral flow velocities during early diastole(E) and atrial contraction(A) were also measured by Doppler echocardiography and E/A ratio, E/Ve ratio were calculated.Result:Mean Ve( 3.64± 1.41 vs 8.21± 1.69,P< 0.01), mean Ve/Va( 0.92± 0.51 vs 1.57± 0.50,P< 0.01) of the mitral annulus in the HCM patients were significantly lower than those in the healthy subjects. E/A and E were lower in the HCM patients than those in the healthy subjects, but there was no significant difference of E between them (E: 74.73±26.55 vs 84.00±14.57,P=0.142;E/A :1.12±0.49 vs 1.68±0.41,P< 0.01). E/Ve was significantly greater in the HCM patients than that in the healthy subjects (23.03±7.73 vs 10.53±2.67,P< 0.01). There were 20 patients with mean Ve/Va<1(64.5%) and 14 patients with E/A<1(45.2%) in the HCM group. Mean Ve and Ve/Va were also significantly lower and E/Ve was significantly greater in the 17 HCM patients with E/A>1 than those in the healthy subjects.Conclusions:Transmitral inflow E and A are influenced by preload, relaxation of myocardium and atrial contraction, but the mitral annular diastolic velocity determined by QTVI can assess accurately the left ventricular diastolic function in HCM patients.

关 键 词：心肌病 肥厚型 多普勒超声心动图 定量组织速度成像 二尖瓣环 左室舒张功能 

分 类 号：R542.2[医药卫生—心血管疾病]