组织多普勒评价冠心病患者升主动脉弹性特征的初步研究  

Doppler Tissue Imaging in Assessing Aorta Elastic Properties and in Predicting Coronary Artery Disease

作　　者：王凯华[1] 陈鹏[2] 章耀[1] 王军[1] 季晓君[1] 林苗[1] 杨琰[3] 

机构地区：[1]温州市第二人民医院心内科心脏彩超科,浙江省温州市325000 [2]温州医学院附属二院心内科 [3]温州医学院附属二院心脏彩超科

出　　处：《中国超声医学杂志》2004年第10期753-756,共4页Chinese Journal of Ultrasound in Medicine

摘　　要：目的　研究多普勒组织成像 (DTI)技术评价升主动脉弹性特征的可行性 ,并进一步探讨升主动脉弹性与冠状动脉狭窄程度之间的关系。方法　对临床拟诊为冠心病的 1 0 6例患者行冠状动脉造影 (CAG)术 ,造影阳性患者为冠心病组 ,阴性患者为对照组 ,并进行冠状动脉狭窄评分 (CAS) ,两组患者在行 CAG前后 1周内行超声心动图检查 ,用 PW- DTI分别测量主动脉瓣上 3cm处升主动脉前壁及二尖瓣侧壁瓣环的 S波、 E波与 A波速度 ,用 M-型内径法测量上述升主动脉相同处收缩期与舒张期内径 (Ds、 Dd) ,用公式计算出升主动脉僵硬度、膨胀性。结果　 (1 )冠心病组与对照组比较 ,升主动脉前壁 S波速度 [(0 .0 5 2± 0 .0 0 9) m/ s vs (0 .0 5 7± 0 .0 1 2 ) m/ s,P<0 .0 5 ]、僵硬度 (2 .34± 0 .39vs 2 .1 1± 0 .6 8,P<0 .0 5 )与膨胀性 [(1 .96± 0 .6 6 ) 1 0 - 6 cm2 / dyn(1 dyn=1 0 - 5N,下同 ) vs (2 .1 9± 0 .4 6 ) 1 0 - 6cm2 / dyn,P<0 .0 5 ]均有统计学意义 ;(2 )经偏相关分析发现 ,升主动脉前壁 S波速度与冠状动脉狭窄程度密切相关 ,且独立于其他冠心病易患因素 ;(3) S波速度与僵硬度呈负相关 (r=- 0 .2 74 ,P=0 .0 1 4 ) ,与膨胀性呈正相关 (r=0 .2 0 7,P=0 .0 2 2 )。结论　升主动脉前壁 S波速度可以直接?Objective To evaluate the feasibility for Doppler tissue imaging (DTI) to assess the elastic properties of aorta,and to discuss the relationship between aorta elastic properties and the severity of coronary artery stenosis Methods Coronary angiography were done in 106 patients Patients with positive results were included in coronary artery disease (CAD) group,while patients with negative results were in the control group Echo cardiography was examined in both groups one week before and after coronary angiography Artery blood pressure was measured just before echocardiographic examination Internal aortic systolic and diastolic diameters were measured with M mode echocardiography and aortic upper wall tissue velocities (aortic S,E,A,m/s) were measured with DTI 3 cm above the aortic valve Lateral mitral annular tissue velocities(annulus S,E,A,m/s) were also recorded Aortic distensibility (10 -6 cm 2×dyn 1 ) and aortic stiffness index were calculated using formulas Results (1)Aortic stiffness(2 34±0 39 vs 2 11±0 68, P <0 05),distensibility[(1 96±0 66)×10 -6 cm 2/dyn vs(2 19±0 46),×10 -6 cm 2/dyn ],P <0 05,and aortic S velocity(0 052±0 009 m/s vs 0 057±0 012m/s, P <0 05),were significantly different between CAD group and the control group;(2)The relationship between the severity of coronary artery stenosis and aortic S velocity was confirmed Partial correlation showed that aortic S velocity was one of the independent risk factors for CAD;(3)Aortic S velocity negatively correlated with aortic stiffness( r =-0 274, P =0 014),and positively correlated with aortic distensibility( r = 0 207, P =0 022) Conclusions Elastic properties of the aorta can directly be assessed by reproducibly measuring the movements in the upper wall of the aorta with DTI Reduced aortic S velocity is associated with increased aortic stiffness which are important predictors of CAD

关 键 词：升主动脉 冠心病 患者 僵硬 冠状动脉狭窄 DTI 组织多普勒 速度 结论 初步研究 

分 类 号：R445.1[医药卫生—影像医学与核医学]