应用二尖瓣环运动速度和时间指标评价冠心病患者左室整体舒张功能(英文)  

Mitral annulus velocities and time intervals for evaluation of global left ventricular diastolic function in patients with coronary artery disease

作　　者：杨莉[1] 邱琼[1] 张惠忠[1] 伍卫[1] 王景峰[1] 

机构地区：[1]中山大学附属第二医院心血管医学部,广东广州510120

出　　处：《中国病理生理杂志》2008年第3期451-455,共5页Chinese Journal of Pathophysiology

基　　金：Supported by the Natural Science Foundation of Guangdong Province(No.031706)

摘　　要：目的:应用脉冲多普勒组织成像(DTI)定量分析并比较心绞痛与心肌梗死(心梗)患者二尖瓣环长轴方向上舒张运动速度和时间变化,探讨其评价左室整体舒张功能异常的价值。方法:冠心病心绞痛组16例、心梗组34例、对照组16例。记录二尖瓣环侧壁、间隔、前壁和下壁的运动频谱。测量舒张早、晚期峰值运动速度及其比值,舒张早期波开始时间、达峰时间和局部等容舒张时间,并计算4个位点的均值,分别以Em、Am、Em/Am、QEm、TEm和IVRTm表示。结果:心绞痛组和心梗组Em和Em/Am显著低于对照组(P<0.01),心梗组Em又低于心绞痛组(P<0.01);心绞痛组和心梗组QEm、TEm及IVRTm显著长于对照组(P<0.01或P<0.05),心梗组IVRTm又长于心绞痛组(P<0.01);IVRTm与Em呈显著负相关(r=-0.64,P<0.01)。结论:脉冲DTI所测Em、Em/Am、QEm、TEm及IVRTm均可反映冠心病患者左室整体舒张功能异常,Em和IVRTm尚可反映心肌缺血损害的严重程度。AIM： To detect and compare the longitudinal mitral annulus diastolic velocity and time interval changes by pulsed Doppler tissue imaging （DTI） in patients with angina pectoris （AP） and myocardial infarction （ MI）, and to explore the value of mitral annulus diastolic velocities and time intervals for evaluation of global left ventricular diastolic dysfunction. METHODS： Fifty patients with established coronary artery disease were divided into AP group （16 cases） and M1 group （34 cases）. Sixteen age -matched healthy individuals served as the control group. The septum, lateral, anterior and inferior walls of the mitral annulus were displayed, and selected for DTI spectrum sampling. Peak early and late diastolic velocities and their ratio, time to the onset and peak of the early diastolic wave, and regional isovolumic relaxation time were measured, and the average values of the four mitral annular sites were calculated and presented as Em, Am, Era/Am, QEm, TErn and IVRTm, respectively. RESULTS： Compared with the control group, Em and Em/Am were significantly lower in both the AP and the M1 groups （P 〈0. 01 ）. Em was even lower in the M1 group than that in the AP group （ P 〈0.01 ）. QEm, TErn and IVRTm were significantly longer in the AP and the MI groups than those in control group （P〈0.01 or P 〈0. 05）. IVRTm was even longer in the M1 group than that in AP group （P 〈0.01）. IVRTm had significantly negative correlation with Em （ r = - 0. 64, P 〈 0. 01 ）. CONCLUSION： Em, Era/Am, QEm, TEm and IVRTm as measured by pulsed DTI may be promising indexes for quantitative assessment of global left ventricular diastolic dysfunction in patients with coronary artery disease. Em and IVRTm may indicate the severity of ischemic myocardial damage.

关 键 词：多普勒组织成像 超声心动描记术 冠状动脉疾病 左心室舒张功能 

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