多普勒组织成像技术对冠心病患者二尖瓣环运动曲线的探讨  

Discussion of Doppler tissue imaging on mitral annulus in patient with coronary artery disease

作　　者：林庆民[1] 王慧芳[1] 韩兆凤[1] 张音佳[1] 

机构地区：[1]上海华东医院超声科,200040

出　　处：《上海医学影像》2003年第2期129-131,共3页Shanghai Medical Imaging

摘　　要：目的 本文旨在运用多普勒组织成像技术观察冠心病患者二尖瓣环运动曲线以评估其左室收缩和舒张功能。 方法32例冠心病患者和20例正常人作对照研究,测定其二尖瓣环后间隔、侧壁、下壁、前间隔和后壁六处各位点的Sa、Ea、Aa及Ea/Aa之比。 结果 1.冠心病患者和正常人二尖瓣环的DTI运动曲线为规律波群,有三个主波,收缩波Sa波,舒张早期Ea波,舒张晚期Aa波 2.冠心病患者二尖瓣环六个节点Sa、Ea及Ea/Aa较正常组显著下降(P<0.01)3.冠心病患者二尖瓣环六个节点平均Sa与左室射血分数呈正相关(r=0.689,P<0.01)平均Ea/Aa与二尖瓣血流曲线E/A之比也有良好相关性(r=0.427 P<0.05)4.正常组与冠心病组心尖四腔观二尖瓣环侧壁Sa、Ea/Aa之比与六个节点平均参数相关系数最大。 结论 DTI测量二尖瓣环运动曲线能同时测定左室收缩、舒张功能,从而提供了一种新的、安全的、直接可靠的、简便的方法。Objective The aim of this study is to assess global LV systolic and diastolic function in patients with CAD using a new technology called Doppler Tissue Imaging (DTI) on the motion of mitral annulus Methods Thirty-two patients with CAD and 20 normal subjects as control group were included, 6 mitral annular sites: septal and lateral from apical 4-chamber views, anterior and inferior from apical 2-chamber view, anteroseptum and posterior from apical 3-chamber views were adopted. The peak systolic and peak early and late diastolic velocities of each of 6 mitral annular site were measured (Sa, Ea, Aa, respectively). Results 1. The spectrum pattern are similar in CAD patients and normal group with three main waves in each cardiac cycle :Sa in systolic and Ea、Aa in diastolic 2. The peak velocity of Sa, Ea and Ea/Aa ratio of each of 6 mitral annular site are significantly lower in CAD patients than normal subjects (P<0.01) 3. In patients with CAD there were close relations between the 6-site average Sa of the mitral annulus and LVEF(r=0.689,P<0.01), and between the average Ea/Aa of mitral annulus and thrasmitral indexes E/A ratio (r=0.42 P<0.05) 4. The Sa of the lateral site of mitral annulus from the apical 4-chamber view correlated most closely with the average Sa in both normal subjects (r=0.774)and CAD patients (r=0.812),the same as the relationship the Ea/Aa ratio of the lateral site of the mitral annular and average Ea/Aa ratio (r=0.562, r=0.585,respectively) Conclusion Mitral annular motion spectrum derived from DTI can reflect systolic and diastolic dysfunction at the same time. It is a new, safe, direct, reliable and easy manner.

关 键 词：多普勒组织成像技术 冠心病 二尖瓣环 运动曲线 冠状动脉 DTI 左室功能 

分 类 号：R541.4[医药卫生—心血管疾病] R445.1[医药卫生—内科学]