脉冲多普勒超声心动图评价左室舒张功能  

The Assess of Pulsed-Wave Doppler Echocardiography on Left Ventricular Diastolic Function

作　　者：郑成环[1] 周长钰[1] 李一丁[1] 蔡金荣[1] 

机构地区：[1]天津医科大学第二医院心脏科,300211

出　　处：《天津医药》2004年第10期623-626,共4页Tianjin Medical Journal

摘　　要：目的 :观察脉冲多普勒超声心动图二尖瓣血流图 (MVFP)、肺静脉血流图 (PVFP)及脉冲多普勒组织成像 (PW -DTI)技术评价对左室舒张功能的价值。方法 :检测冠心病左房增大组61例 ,冠心病左房正常组31例及47例正常对照组各参数变化 ,其中部分人行冠脉和左室造影检查。结果 :正常人MVFP的E、A峰的峰速比值(EV/AV)>1,E波减速时间(EDT)<200ms ,PVFP的S峰速(VS)>D峰速(VD),肺静脉心房收缩波时间(ARD)<二尖瓣心房收缩波时间(AD) ;DTI的舒张早期与晚期峰速度比 (e/a)>1,舒张早期峰速Ea>10cm/s,冠心病左房正常组MVFP的EV/AV<1 ,EDT>200ms ;PVFP的VS/VD增大 ,肺静脉收缩分数 (SF)增大 ,房缩波峰速 (VAR)<30cm/s,DTI的e/a<1 ;冠心病左房增大组MVFP中仅EDT<150ms,余无差异 ,PVFP中VS/VD<1,SF减小 ,VAR>30cm/s,ARD>AD。DTI的e/a<1,等容舒张期 (IVRT)延长 ,二尖瓣侧环e/a比与左室舒张末压 (LVEDP)呈负相关 (r= -0.23,P<0.05)。结论 :脉冲多普勒超声心动图记录二尖瓣口血流频谱及DTI诊断左室舒张早期功能不全较敏感 ,EV/AV<1 ,e/a<1 ,直观通用 ,当MVFP出现假性正常时 ,PVFP能很好识别 ,DTI二尖瓣侧环e/a比值能半定量评价左室舒张功能损伤程度。Objective:To evaluate the effects of pulsed Doppler mitral valve flow pattern,pulmonary venous flow pattern and mitral annular velocity detected by tissue Doppler imaging on evaluating left ventricular dias-tolic function.Methods:Sixty-one cases of coronary heart disease with enlarged left artrium and31cases of coronary heart disease with normal left artrium were observed,and compared with normal control.Some of the patients were examined by coronary and left ventricular angiography.Results:In normal control,MVFP:EV/AV>1,EDT<200ms,PVFP:VS>,ARD<AD;DTI:e/a>and Ea>cm/s.In CAD with normal left atrium,MVFP:EV/AV<1,EDT>0ms;PVFP:VS/VD>systolic fraction of pulmonary vein in-creased,VAR<30cm/s,and DTI:e/a<1.In CAD with enlarged left atrium,MVFP:only EDT<150ms,PVFP:VS/VD<1,systolic fraction of pulmonary vein decreased,VAR>cm/s,ARD>,DTI:e/a<1,and IVRT prolonged.Lateral mitral annular e/a ration was negatively correlated with left ventricular end di-astolic pressure(r=-0.023,P<0.05).Conclusion:Early left ventricular diastolic function dysfunction can be diagnosed sensitively by EV/AV ratio<1in MVFP and e/a<1in DTI.PVFP can distinguish it when pseudonormalization was present in MVFP.DTI e/a ratio can semiquantily assesse damage degree of left ven-tricular diastolic function.

关 键 词：DTI 左室舒张功能 二尖瓣 冠心病 超声心动图 正常 VD 分数 结论 速度比 

分 类 号：R541[医药卫生—心血管疾病] R544.1[医药卫生—内科学]