组织多普勒成像Tei指数及三尖瓣环运动速度参数评价原发性高血压病患者右心室功能

目的 应用组织多普勒成像(TDI)技术检测Tei指数(TDI-Tei)及三尖瓣环运动速度参数,评价原发性高血压病患者右心室功能的变化.方法 选取140例原发性高血压病患者,其中左心室肥厚(LVH)组69例,非左心室肥厚(NLVH)组71例,另外选取正常健康者50例作为对照组.脉冲多普勒测量三尖瓣口舒张早期血流速度(E)、舒张晚期血流速度(A),计算E/A比值；脉冲TDI测量右心室侧壁三尖瓣环处的TDI-Tei及收缩期峰值运动速度(Sm)、舒张早期峰值运动速度(Em)、舒张晚期峰值运动速度(Am),计算Em/Am比值.结果 LVH组与NLVH组Em[(8.9±2.4)、(11.2±2.5)cm/s]、Em/Am比值[0.56±0.15、0.76±0.16]均明显低于对照组[分别为(13.1±3.2)cm/s、0.93±0.19],差异均有统计学意义(均P＜0.05).LVH组与NLVH组TDI-Tei(0.54±0.12、0.41 ±0.08)均明显高于对照组(0.33±0.06),差异有统计学意义(P＜0.05).LVH组Sm[( 12.3±2.3)cm/s]明显低于对照组[(13.8±2.3)cm/s],差异有统计学意义(P＜0.05).LVH组与NLVH组TDI-Tei与E/A比值、Em、Em/Am比值和Sm呈明显负相关(分别为r=-0.412、r=-0.526、r=-0.498、r=-0.371,P＜0.01).结论 TDI-Tei联合三尖瓣环运动速度参数能够客观、全面地评价原发性高血压病患者的右心室功能障碍.

Assessment of right ventricular function by tissue doppler imaging Tei index and tricuspid annular velocityparameters in essential hypertension

Objective To investigate the changes of right ventricular function in essential hypertension by pulse-wave tissue doppler imaging（TDI）and TDI-Tei index. Methods One hundred and forty elderly hypertensive patotions were divided into LVH group（69 patients with left ventricular hypertrophy）and NLVH group（71 patients without left ventricular hypertrophy）. Control group consisted of 50 normal subjects. The index of echocardiography, including the tricuspid valve flow velocity during early and late diastole（ E, A）, ratio of E/A, peak velocities of RV lateral wall site at tricuspid annular during systole, early and late diastole （Sm, Era, Am）, ratio of Era/Am and TDI-Tei were measured respectively. Results Compared with normal group, Em [ （ 8.9 ＋- 2.4 ） cm/s, （ 1 t. 2 ＋- 2.5） cm/s ] and Em/Am（0. 56 ＋ 0. 15, 0. 76 _＋ 0. 16）in LVH and NLVH groups were statistically different（ P 〈 0.05 ）. TDI-Tei index （0. 54 -e 0. 12, 0. 41 ＋ 0.08 ） was statistically different （ P 〈 0. 05 ）. Compared with normal group[ （ 13.8 ＋ 2. 3） cm/s ], Sm of LVH group [ （ 12. 3 -＋ 2. 3 ） cm/s ] was statistically different （ P 〈 0.05 ）. The TDI-Tei index was negatively correlated with E/A, Era, Em/Am and Sm（ r -- -0. 412, r = -0. 526, r = -0. 498, r = -0. 371, all P 〈 0. 01 ）. Conclusions TDI-Tei index, TDI-derived Sm, Em and Em/Am are valuable indexes to evaluate RV dysfunction in hypertension.