脉冲多普勒组织成像评价冠状动脉搭桥手术前后右心室壁运动的初步研究  

Assessment of right ventricular wall motion on patients with right coronary artery diseases before and after coronary artery bypass graft by Doppler tissue imaging

作　　者：程蕾蕾[1] 舒先红[1] 谭德英[2] 葛均波[1] 沈学东[1] 陈灏珠[1] 

机构地区：[1]复旦大学附属中山医院上海市心血管病研究所,上海200032 [2]长春中医学院附属医院电诊科

出　　处：《中华超声影像学杂志》2002年第12期713-715,共3页Chinese Journal of Ultrasonography

摘　　要：目的　探讨脉冲多普勒组织成像 (PW DTI)评价右冠状动脉狭窄患者在冠状动脉搭桥手术(CABG)前后右室壁运动的变化。方法　 16例研究对象均行冠状动脉造影证实右冠状动脉狭窄≥ 5 0 % ,2例为单纯右冠状动脉狭窄 ,14例合并不同程度的左冠状动脉病变 ( 2 0 %～ 85 % )。均在本院行CABG以改善其右冠状动脉血供。术前 1周和术后 3个月分别在右室游离壁基底段、中段和心尖段行PW DTI测定其室壁运动。结果　右冠状动脉病变者在CABG手术前后右室游离壁基底段、中段的收缩期S波峰值速度 (S)和积分 (S VTI)术后较术前增加 (P <0 .0 1～ 0 .0 5和P <0 .0 5 )。基底段心电图QRS波起始至E波起始时间 (Q E)较术前缩短 (P= 0 .0 5 )。结论　CABG前后 ,右室游离壁基底段和中段的S、S VTI增加以及基底段的Q E缩短 。Objective To investigate changes of right ventricular function with PW-DTI on patients with right coronary artery diseases before and after coronary artery bypass graft (CABG).Methods The study population included 16 consecutive patients performed recent coronary angiography with the right coronary narrowing(≥50% diameter stenosis).Fourteen patients also had different degrees of left coronary narrowing(20%～85% diameter stenosis) while two patients only had right coronary stenosis.PW-DTI sampling volume was placed at basal,middle and apical of right ventricular(RV) free walls and at basal of left ventricular(LV) free walls.The maximum velocity (S) and the velocity integral (S-VTI) during the ejection phase,the maximum velocity during the early(E),and late(A) diastole,the time interval from the onset of QRS wave of the ECG to the emergy of E (Q-E)and the peak diastolic velocity (Q-Ep)were measured 1 week before CABG and 3 months after the operation.Results Close to the tricuspid annulus and the middle of RV free walls,S and S-VTI were larger than those before the operation( P < 0.01 ～ 0.05 and P < 0.05 ).Q-E at basal segment was shortened ( P = 0.05 ).These results are not related to the stenosis severity.Conclusions The abnormal motion of the free walls of RV at basal detected by PW-DTI is highly feasible.The increasement of S and S-VTI at basal and the middle of RV free walls and the decrease of Q-E at basal segment would be new indexes for diagnosing the improvement of CABG in patients with right coronary artery diseases.

关 键 词：脉冲多普勒组织成像 冠状动脉搭桥手术 冠状动脉分流术 右心室功能 冠状动脉狭窄 

分 类 号：R445.1[医药卫生—影像医学与核医学]