脉冲组织多普勒对冠心病患者左室局部舒张功能变化的研究  

Assessment of regional myocardial function in patients with hypertrophic cardiomyopathy by tissue strain imaging

作　　者：杨莉[1] 伍卫[1] 王景峰[1] 张小玲[1] 

机构地区：[1]中山大学附属第二医院心内科,广东广州510120

出　　处：《中国医学影像技术》2005年第11期1701-1703,共3页Chinese Journal of Medical Imaging Technology

摘　　要：目的应用脉冲组织多普勒成像(TDI)定量分析并比较心绞痛与心肌梗死(心梗)患者左室壁不同节段心肌长轴方向舒张运动速度和时相变化,评价TDI速度和时间参数检测左室局部舒张功能异常的价值。方法冠心病心绞痛组16例、前壁心梗组21例,对照组16例。记录左室侧壁、间隔、前壁和下壁基底段及中段心肌运动频谱。检测指标:心肌舒张早期峰值速度(e)、心肌舒张晚期峰值速度(a)、e/a比值、e波开始时间(QE)、e波峰值时间(Te)和局部等容舒张时间(IVRT)。结果冠心病两组各节段e和e/a均显著降低;前壁心梗组梗死较非梗死节段a和e降低、e/a显著增大。冠心病两组QE、Te和IVRT均显著延长;但前壁心梗组与心绞痛组比较,仅IVRT显著延长。结论TDI所测e、e/a、QE、Te和IVRT均可敏感反映冠心病患者左室局部舒张功能异常;IVRT还可反映心肌缺血损害的严重程度。Objective To quantitatively analyze and compare the longitudinal myocardial diastolic velocity and time intervals of the left ventricle in patients with angina pectoris （AP） with those in patients with myocardial infarction （MI）, and to explore the value of diastolic velocity and time intervals measured by pulsed tissue Doppler imaging （TDI） in detecting re gional left ventricular diastolic dysfunction. Methods Patients with coronary artery disease （CAD） were divided into AP group （16 cases） and anterior wall MI group （ant-MI, 21 cases）. Sixteen age-matched normal subjects served as a control group. The septum and lateral, anterior and inferior wall of the left ventricle were displayed respectively, and basal and mid die segments of each wall were selected for myocardial motion spectrum sampling. TDI parameters were： peak early diastolic velocity （e）, peak late diastolic velocity （a）,e/a ratio, time to the beginning of e wave （QE）, time to the peak of e wave （Te） ,regional isovolumic relaxation time （IVRT）. Results Compared with the control group, e and e/a were significantly lower in all segments in AP group and ant- MI group. The a and e were lower, but e/a was higher in infarct segments than corresponding non-infarct segments in ant-MI group. The QE, Te and IVRT were significantly longer in both AP group and ant-wall-MI group. However, only IVRT was longer in ant wall-MI group than in AP group. Conclusion The e, e/a, QE, Te and IVRT measured by TDI are all sensitive markers of regional left ventricular diastolic dysfunction in patients with CAD, and IVRT may also respond to the severity of myocardial ischemia.

关 键 词：组织多普勒成像 超声心动描记术 冠心病 心室功能 左 

分 类 号：R540.45[医药卫生—心血管疾病] R542.22[医药卫生—内科学]