应用二尖瓣环舒张早期运动速度评价冠心病患者左心室舒张功能

目的探讨组织多普勒成像(TDI)测得的二尖瓣环舒张早期速度评价左心室舒张功能的临床应用价值,以及不同冠状动脉病变对左心室舒张功能的影响。方法54例胸痛患者经冠状动脉造影检查,排除冠心病的14例作为对照组,冠心病的40例分为一支病变组、两支病变组、三支轻度组和三支重度组。测量二尖瓣环间隔部和侧壁部舒张早期峰速度Esep和Elat,计算两者的均值Ea以及二尖瓣舒张早期血流速度(E)与三者的比值E/Esep、E/Elat和E/Ea。结果冠心病组与对照组相比,Esep、Elat、Ea、E/Esep、E/Elat和E/Ea均有差异,且病变越重,差异越明显。以冠状动脉造影为金标准,E/Ea>8.35诊断冠心病的敏感度和特异度分别为75%和100%。结论二尖瓣环舒张早期速度是评价左心室舒张功能的良好指标。E/Ea评价的左心室舒张功能可帮助诊断冠心病和判定冠状动脉病变的严重程度。

Assessment of left ventricular diastolic function in patients with coronary artery disease by early diastolic velocity of mitral annulus

Objective To assess the clinical value of early diastolic velocity of mitral annulus detected by tissue Doppler imaging(TDI)in left ventricular diastolic function evaluation,and to observe how coronary lesions affect left ventricular diastolic function.Methods Fifty-four patients with chest pain who undertook coronary angiography were selected,14 of whom were excluded CAD and served as control group,and the other 40 were divided into univessel group(n=10),bivessel group(n=11),moderate trivessel group(n=9)and severe trivessel group(n=10).The early diastolic velocity of mitral annulus from septal(Esep)and lateral(Elat)part was measured by TDI.The mean values Ea of Esep and Elat were calculated as well as the ratio of the mitral valve blood velocity(E).Results Compared with the controls,Esep,Elat,Ea,E/Esep,E/Elat and E/Ea were different in coronary groups and the differences became more obvious with more severe lesions.The sensitivity and specificity to diagnose CAD by E/Ea>8.35 were 75% and 100%,respectively.Conclusion The early diastolic velocity of mitral annulus is a good index for evaluating left ventricular diastolic function.The left ventricular diastolic function assessed by E/Ea may help diagnose CAD and provide a reference for coronary lesion severity evaluation.