二尖瓣环运动时相评估左室舒张功能  

Assessment of left ventricular diastolic function by phase analysis of mitral annular movement

作　　者：牟芸[1] 胡瑛[1] 姚磊[1] 郑哲岚[1] 徐启彬[1] 

机构地区：[1]浙江大学医学院附属第一医院超声科,杭州310000

出　　处：《浙江医学》2003年第11期654-655,共2页Zhejiang Medical Journal

摘　　要：目的 探讨二尖瓣环时相评估左室舒张功能的临床意义。方法 20名正常人 ,20例高血压病人 ,20例冠心病病人 ,以组织多普勒的脉冲多普勒模式检测二尖瓣环运动频谱和二尖瓣口血流频谱 ,比较二尖瓣环舒张早期波 (Ea)起始与血流E起始、Ea峰值与E峰值的早晚。结果 二尖瓣环运动速度和二尖瓣口血流速度均显示高血压病人与冠心病患者存在左室舒张功能减退。冠心病患者同时合并左室收缩功能下降。高血压病人Ea起始、Ea峰值分别早于E起始、E峰值 ,与正常人无显著差异。冠心病患者Ea起始、Ea峰值分别晚于E起始、E峰值 ,与正常人差异显著。结论 单纯左室舒张功能减退早期或正常人 ,二尖瓣环舒张早期运动早于血流运动 ,若迟于血流运动时表明舒张功能受损更严重 ,且往往合并左室收缩功能不全。Objective To investigate the clinical value of phase analysis by mitral annular movement in assessment of left ventricular diastolic function.Methods Twenty patients with hypertension, 20 with coronary artery disease (CAD) and 20 normal subjects were included in the study.After routine echocardiograghy, mitral annular movement was displayed by DTI-PWD and mitral inflow was measured by pulsed wave Doppler.The phase of mitral annular early diastolic wave (Ea) onset was compared with E onset and the phase of Ea peak was compared with E peak.Results Mitral annular velocity and mitral inflow velocity indicated the left ventricular diastolic dysfunction in two patient groups.The CAD group was complicated with left ventricular systolic dysfunction.In normal group and hypertension group,the onset of Ea wave preceded the onset of E wave.The peak of Ea wave preceded the peak of E wave. In CAD group, the onset of Ea wave was later than the onset of E wave.The peak of Ea wave was later than the peak of E wave.Conclusion When the mitral annular early diastolic velocity precedes the mitral inflow velocity,it may indicate normal condition or early stage of left ventricular diastolic dysfunction.In contrast,when the mitral inflow velocity preceded the mitral annular early diastolic velocity,it may implicate severe left ventricular diastolic dysfunction complicated with systolic dysfunction.

关 键 词：二尖瓣环运动 时相评估 左室舒张功能 二尖瓣血流 多普勒组织成像 

分 类 号：R445.1[医药卫生—影像医学与核医学]