彩色M型多普勒和应变率成像技术评价高血压患者左室舒张功能的临床研究

目的:应用彩色M型多普勒(CMM)和应变率成像(SRI)技术评价高血压患者左室舒张功能,探讨CMM和SRI评价左室舒张功能的临床价值。方法:高血压患者30例,根据二尖瓣口血流舒张早期和晚期峰值速度比值(E/A)分为两组:Ⅰ组E/A<1,19例,Ⅱ组E/A≥1,11例;正常对照组30例。于心尖四腔观,应用彩色M型多普勒技术测量左室舒张早期血流播散速度(FPV);获取心尖四腔观、三腔观和两腔观组织速度成像(TVI)的图像,应用应变率成像技术分析左室各节段心肌舒张期应变率曲线,并计算左室平均峰值应变率(mSR)和左室平均应变率播散速度(PVS)。结果:与正常对照组相比,高血压Ⅰ组(E/A<1)和Ⅱ组(E/A≥1)患者的左室舒张早期血流播散速度(FPV)、左室舒张早期平均峰值应变率(mSRe)、左室舒张早期和晚期平均峰值应变率的比值(mSRe/mSRa)及左室舒张早期应变率传播速度(PVSe)均有明显下降(P<0.01)。结论:应用彩色M型多普勒和应变率成像技术能准确评价高血压患者的左室舒张功能,并且不出现伪正常现象。

A Clinical Study of Color M-mode Doppler Echocardiography and Strain Rate Imaging in Evaluating the Left Ventricular Diastolic Function in the Patients with Hypertension

Objective: To evaluate the left ventricular diastolic function in patients with hypertension by color M-mode Doppler echocardiography(CMM) and strain rate imaging(SRI) and to compare the results.Methods: Thirty patients with hypertension which were divided into two groups according to the ratio of mitral valve peak flow velocity in early diastole(E) and atrial systole(A): group Ⅰ,E/A<1(n=19) and group Ⅱ,E/A≥1(n=11).Another 30 normal volunteers accepted CMM and SRI examination.Flow propagation velocity in left ventricle in diastole rate(FPV) was measured with CMM at a four-chamber view.SRI were applied for obtaining early diastolic and atrial contraction strain rate(SR),mean strain rate(mSR) and strain rate propagation velocity(PVS) of the left ventricular middle and basal segments at two-chamber,three-chamber and four-chamber views.Results: Compared with the controls and patients with hypertension,FPV,mSRe,mSRe/mSRa and PVSe descreased significantly(all P<0.01).Conclusion: CMM and SRI can assess diastolic function more reliably than mitral valve peak flow velocity,and there is no pseudo-nomalization.