药物负荷超声心动图组织多普勒评价心肌缺血研究  

Evaluation of myocardial ischemia by pharmacological stress echocardiography and tissue Doppler imaging

作　　者：毛萍[1] 周李涛[1] 徐晨凯[1] 孙寅光 唐礼江[1] MAO Ping;ZHOU Litao;XU Chenkai(Department of Cardiology,Zhejiang Hospital,Hangzhou 310007,China)

机构地区：[1]浙江医院心内科,杭州310007 [2]上海璞迈医疗投资管理有限公司

出　　处：《心电与循环》2018年第2期90-95,共6页Journal of Electrocardiology and Circulation

基　　金：浙江省医药卫生重大科技计划项目(2017C03034);浙江省公益技术研究计划项目(LGJ18H020001)

摘　　要：目的研究药物负荷超声心动图组织多普勒成像(TDI)技术评估心肌缺血的意义。方法前降支50%~80%狭窄伴典型胸痛患者42例,行多巴酚丁胺药物负荷试验及冠状动脉血流储备分数(FFR)检查,以FFR<0.8为心肌缺血组(17例),FFR≥0.8为非心肌缺血组(25例)。测量两组患者药物负荷前和药物负荷状态下的前降支供血左心室8节段收缩期峰值速度(Vs)、舒张早期峰值速度(Ve),舒张晚期峰值速度(Va)。结果药物负荷试验前,两组左心室8节段平均Vs、Ve、Va比较,差异均无统计学意义(均P>0.05)。药物负荷状态下,非心肌缺血组左心室8节段平均Vs、Ve[(5.26±1.75)、(5.66±1.89)cm/s]大于心肌缺血组[(3.61±0.98)、(4.03±1.08)cm/s],差异均有统计学意义(t=-3.16,-2.88,均P<0.05)。药物负荷状态下,两组患者左心室8节段平均Va差异无统计学意义(P>0.05)。结论药物负荷超声心动图组织多普勒显像能用于心肌缺血的评估。Objective To determine the value of pharmacological stress echocardiography and tissue Doppler imaging in evaluation of myocardial ischemia.Methods Forty-two patients with angina and left anterior descending artery stenosis of 50%~80%were enrolled.Dobutamine stress echocardiography and intracoronary fraction flow reserve(FFR)test were performed in all of them.They were divided into ischemic group(n=17)and non-ischemic group(n=25)based on whether FFR<0.8 or not.The peak systolic velocity(PSV,Vs),early and late peak diastolic velocity(PDV,Ve,Va)of eight left ventricular segments supplied by left anterior descending artery were measured at baseline and during pharmacological stress test.Results The PSV,early and late PDV were comparable between the two groups at baseline.The PSV and early PDV were significantly higher in non-ischemic group than in ischemic group during pharmacological stress test[(5.26±1.75)cm/s vs.(3.61±0.98)cm/s,(5.66±1.89)cm/s vs.(4.03±1.08)cm/s](all P<0.05).The late PDV was not significant difference between the two groups.Conclusion Pharmacological stress echocardiography and tissue Doppler imaging may be used to evaluate myocardial ischemia.

关 键 词：药物负荷试验 组织多普勒 心肌缺血 冠状动脉血流储备分数 

分 类 号：R54[医药卫生—心血管疾病]