多普勒组织成像检测心肌长轴等容收缩期运动评价扩张型心肌病患者左心室整体收缩功能  

Assessment of left ventricular global systolic function by measuring myocardial long axis motion indices during isovolumic contraction with Doppler tissue imaging in patients with dilated cardiomyopathy

作　　者：张连仲[1] 谢明星[1] 王新房[1] 

机构地区：[1]华中科技大学同济医学院超声影像科,武汉430022

出　　处：《中华超声影像学杂志》2007年第10期836-839,共4页Chinese Journal of Ultrasonography

摘　　要：目的探讨心肌长轴等容收缩期多普勒组织成像（DTI）指标评价扩张型心肌病（DCM）患者左心室整体收缩功能的价值。方法应用DTI检测了33例DCM患者左心室侧壁、后间隔、前壁、下壁、前间隔及后壁基底段心肌长轴等容收缩期运动,并与30例正常人对比分析,测量心肌等容收缩期正向波峰值速度（VIVC1）、负向波峰值速度（VIVC2）,计算正负向波峰值速度差值（DIVC）、6个壁VIVC1均值（MVIVC1）、VIVC2均值（MVIVC2）及DIVC均值（MDIVC）。在胸骨旁左心室长轴观测量左心室舒张末前后径（LVEDd）,应用改良Simpson法测量左心室射血分数（LVEF）。结果DCM患者左心室侧壁、前壁、下壁及后壁VIVC1、DIVC及MVIVC1、MDIVC较对照组明显降低（P〈0.01）,下壁、后间隔壁VIVC2及MVIVC2增大（P〈0.05～0.01）,余各壁上述指标两组差异无统计学意义（P〉0.05）。左室侧壁、前壁、下壁、后壁基底段心肌等容收缩期VIVC1、DIVC及MVIVC1、MDIVC与LVEF均呈明显正相关（P〈0.01）;前、后间隔VIVC1、DIVC、6个壁VIVC2及MVIVC2与LVEF均无明显相关性。结论DCM患者左心室基底段心肌长轴等容收缩期MVIVC1、MDIVC等测值具有特征性变化,且与LVEF相关良好,可作为左心室整体收缩功能评价的新方法应用于临床。　Objective To assess left ventricular global systolic function by myocardial long axis motion indices during isovolumic contraction phase with Doppler tissue imaging（DTI） in patients with dilated cardiomyopathy（DCM）.Methods Left ventricular myocardial long axis motion DTI during isovolumic contraction phase were examined in 33 patients with DCM and 30 normal controls,and the sample volume was placed at basal septal and lateral walls from apical 4-chamber views,anterior and inferior walls from 2-chamber views,antero-septal and posterior walls from 3-chamber views.Peak positive and negative velocities（VIVC1,VIVC2） and their different values （DIVC） of myocardial motion DTI during isovolumic contraction phase were measured,and the mean values of VIVC1,VIVC2 and DIVC of the six walls（MVIVC1,MVIVC2,MDIVC）were calculated.Left ventricular end diastolic diameters were measured from parasternal left cardiac long axis views.Left ventricular ejection fraction （LVEF） was calculated by modified Simpson＇s method.Results VIVC1,DIVC of lateral,anterior,inferior and posterior walls and MVIVC1,MDIVC were significantly decreased（P〈0.01） in patients with DCM compared with control group,VIVC2 of inferior,posterior walls and MVIVC2 were increased（P〈0.05～0.01）.There were no significant statistic differences between two groups for VIVC1 of antero-septal,septal walls and VIVC2 of lateral,anterior,antero-septal,posterior walls（P〉0.05）.Statistic analysis showed there were good correlations between VIVC1,DIVC of left ventricular basal lateral,anterior,inferior and posterior walls as well as MVIVC1,MDIVC and LVEF（P〈0.01）.All other indices had no correlations with LVEF.Conclusions Indices of MVIVC1,MDIVC etc from left ventricular basal walls myoccordial long axis motion during isovolumic contraction have characteristic changes in patients with DCM,and correlate well with LVEF,which can be used as a new method for evaluating left ventricular global systolic function.

关 键 词：超声心动描记术 心肌病 扩张型 心肌收缩 心室功能 左 

分 类 号：R686[医药卫生—骨科学]