定量组织速度成像评价高血压性心脏病左室心肌功能  

Assessment of left ventricular function in patients with essential hypertension(EH) using qantitative tissue velocity imaging

作　　者：陈纪平[1] 王良玉[1] 蔡志雄[1] 柯斌[1] 

机构地区：[1]广东汕头市中心医院心内科,515031

出　　处：《中国基层医药》2004年第4期402-404,共3页Chinese Journal of Primary Medicine and Pharmacy

摘　　要：目的　探讨定量组织速度成像 (QTVI)技术评价原发性高血压 (EH)左室心肌收缩与舒张功能的价值。方法　应用QTVI获取 4 0例正常人和 4 0例EH病人左室长轴方向左室前壁、后壁、下壁、侧壁及室间隔的心肌多普勒速度曲线 ,分别比较以下参数 :①不同室壁中部心肌运动收缩期峰值速度 (Vs)、快速充盈期和心房收缩期的速度 (Ve和Va)、收缩期内外膜下心肌峰值速度阶差 (MVG) ;②左房室瓣舒张期血流频谱E/A值、左室射血分数 (LVEF)、左室质量指数 (LVMI)、Vs/Ve、Va/Ve比值。结果　①EH病人Vs、Ve、Va、MVG、Vs/Ve、LVEF均较正常人低 ,LVMI、Va/Ve比正常人高 (P <0 0 5 ) ;②若以MVG >0 75cm/s、Vs/Ve>0 80作为判定病人心功能符合临床NYHA分级Ⅰ～Ⅱ级、客观评分A～B级、LVEF >4 5 %的界定值 ,其敏感性 85 % ,特异性 82 % ,阳性预测值 81%。结论　QTVI定量评价EH病人左室心肌功能 ,为进一步了解EH局部心肌收缩舒张功能变化及其局部与整体心肌功能的变化提供较为敏感、精确的方法。Objective This study was designed to assess the left ventrlcular(LV) regional systolic and diastolic function,left ventricular wall motion features in patients with essential hypertension(EH) using qantitative tissue velocity imaging.Methods Forty normal subjects and forty EH patients underwent QTVI study.Off-line LV regional velocity imaging and displacement profiles along LV apical long-axis view were obtained synchronously.Peak tissue velocities of LV regional muscular tissue during systole(Vs),early diastole(Ve),LA contraction(Va),systolic velocity gradient(MVG) between endocardium and epicardium in the middle segments of LV,LV ejection fraction (LVEF),mitral valve peak flow velocity E/A ratio,left ventricular mass index(LVMI) were measured in and compared between normal subjects and EH patients.Results (1)Vs,Va,Ve,Vs/Ve,LVMI,MVG,LVEF were significant reduced in EH patients than in normal subjects and LVMI,Va/Ve were higher in EH patients.(2)Using MVG>0.75cm/s and Vs/Ve>0.80 to evaluate early LV function(against NYHA classⅠ～Ⅱ,Objective evaluating class A～B and LVEF>45%) in EH patients,higher sensitivity(85%),specificity(82%),and postive predictive value(81%) were obtained.Conclusion QTVI offers a newer method for clinical practice which has a higher sensitivity and accuracy in evaluating LV regional systolic and diastolic function in EH patients.

关 键 词：定量组织速度成像 高血压 心脏病 左室心肌功能 并发症 

分 类 号：R541.3[医药卫生—心血管疾病]