组织多普勒成像与血浆脑钠肽对舒张性心衰患者右心功能的评估

目的通过组织多普勒超声与血浆脑钠肽（BNP）水平测定，了解左室收缩功能正常的心衰患者（HFNEF）的右室功能，评估无创检查对观察HFNEF患者右心功能的价值。方法选取HFNEF的心衰患者30例，健康对照组28名，分别进行血浆BNP水平测定与组织多普勒超声检查。通过测定右室射血分数（RVEF）、舒张早期和晚期三尖瓣血流峰值速度（E与A）、三尖瓣舒张早期和晚期峰值运动速度（Et与At），计算E／A、Et／At、E／Et值和右室Tei指数。结果与对照组相比，HFNEF组患者RVEF值明显降低（49．79±5．49比56．35±6．43，P〈0．01）；E／Et明显升高（8．81±3．23比4．87±0．70，P〈0．01）；Tei指数显著增高（0．44±0．10比0．33±0．08，P〈0．01）。两组间血浆BNP水平差异无统计学意义。结论左室收缩功能正常的心衰患者右室收缩和舒张功能均受损。多普勒超声的无创检查对左室收缩功能正常的心衰患者右心功能的评估要优于BNP测定。

Evaluation of right ventricle function of patients with diastolic heart failure by tissue Doppler imagine and serum levels of brain natriuretic peptide

Objective Evaluation the effect of noninvasive detections on right ventricle function of patients with diastolic heart failure by tissue Doppler imagines and serum levels of brain natriuretic peptide. Methotis Thirty patients with diastolic heart failure were in group HFNEF, twenty-eight patients with normal heart function were in group contrast. The plasma level of BNP of each patient was detected, right vantricular ejection fraction （RVEF）, E/A, E/Et, and Tel index were measured by echocardiography. Results Compared with the contrast group, the RVEF of HENEF group was reduced significantly （49.79±5.49 vs 56.35±6.43, P〈0.01 ）, and the E/Et enhanced markedly （8.81±3.23 vs 4.87±0.70, P〈0.01 ）, the Tel index increased remarkably （0.44±0.10 vs 0.33±0.08,P〈0.01 ）. There was no significant difference of serum levels of BNP between two groups. Conclu- sion The systolic and diastolic functions of right ventricle are damaged in heart failure with normal left ejection fraction patients. Tissue Doppler imagines provides better supervision than the serum level of BNP of diastolic heart failure.