稳定型心绞痛患者左室舒张功能的超声研究

目的应用多普勒组织成像(DTI)技术检测二尖瓣环舒张期运动速度,评价稳定型心绞痛患者冠脉病变数量与左室整体舒张功能的关系。方法75例稳定型心绞痛患者,根据冠状动脉造影结果,分为单支病变组(31例)、二支病变组(19例)、三支病变组(25例)。用DTI测定室间隔和左室侧壁舒张早期、舒张晚期二尖瓣环运动峰值速度之比值(Ea/Aa),并与超声心动图常规指标E/A比值等作对照分析。结果单支病变与二支病变、三支病变与二支病变的患者超声心动图各项指标均无显著差异。三支病变较单支病变患者A峰高(P<0.05),E/A比值下降(P<0.05);DTI室间隔和侧壁部Ea下降(P<0.01),室间隔和侧壁部Ea/Aa下降(P<0.05);室间隔和侧壁部E/Ea增高(P<0.01,P=0.05)。结论稳定型心绞痛患者的左室舒张功能与冠脉病变数量有关,三支病变较单支病变患者的左室舒张功能更为下降。

Assessment of Left Ventricular Diastolic Function by Doppler Tissue Imaging in Patients with Stable Angina Pectoris

Objective This study is to assess the clinical utility of mitral annulus velocity measured by Doppler tissue imaging (DTI) in evaluation of left ventricular (LV) diastolic function in stable angina pectoris and to determine whether the quantity of the lesion of the coronary artery is related to diastolic function. Methods Seventy-five stable angina pectoris patients were divided into three groups based on angiography: one-vessel lesion, two-vessel lesion and three-vessel lesion groups. Peak velocities of E wave (Ea) and A wave (Aa) of the mitral annulus at the points of interventricular septum and lateral wall were measured and the Ea/Aa ratio was calculated. Results There were no differences between one-vessel lesion and two-vessel lesion patients with stable angina pectoris, as well as two-vessel lesion and three-vessel lesion. However, there were significant differences between one-vessel and three-vessel lesion patients of A (P<0.05),E/A(P<0.05)and septal Ea(P<0.01),E/Ea (P<0.01),lateral Ea (P<0.01), Ea/Aa (P<0.05), E/Ea (P=0.05) in the mitral annulus velocity measurement by TDI. Conclusion The LV diastolic dysfunction of stable angina pectoris patients is related to the quantity of the coronary artery lesion, the three-vessel lesion patients' LV diastolic function is lower than the two-vessel lesion.