应用二尖瓣环运动速度评价冠心病患者左室功能的研究

目的 :探讨与常规超声相比 ,DTI测量二尖瓣环运动速度以评价左室功能的临床应用价值。方法 :研究对象为 33例冠心病的患者和 19例健康志愿者。常规超声心动图检查后 ,应用DTI测量二尖瓣环 6个节段的Sa、Ea和Aa及节段性等容舒张时间。结果 :(1)常规超声未检出冠心病不伴心梗组左室整体或节段性收缩功能减退 ,冠心病组常规二尖瓣血流E/A之比和肺静脉血流S/D之比与正常组相比也无显著性差别 ,然而DTI显示 ,冠心病不伴心梗组二尖瓣环 6个节段Sa、Ea、Ea/Aa之比显著低于正常组 ,冠心病伴心梗组上述参数降低更为显著。 (2 )冠心病组二尖瓣环 6个节段平均Sa与LVEF呈高度正相关 ,r值为 0 .746 (P <0 .0 0 1)。结论 :DTI测量二尖瓣环 6个节段的运动速度能定量评价冠心病患者左室整体和节段性功能 ,较常规超声敏感 ,有助于冠心病患者的早期诊断和随访。

Quantitative Assessment of Left Ventricular Function in Coronary Artery Disease by Mitral Annulus Velocity

Objective: To explore the advantages of mitral annulus velocity measured by DTI to evaluate LV function compared to the conventional echocardiography. Methods: 33 patients with coronary artery disease(CAD) were compared with 19 healthy subjects. Besides the conventional echocardiographic examination, Sa?Ea?Aa and IVRTa of each of 6 mitral annulus sites were measured by DTI. Results: 1. Compared with healthy subjects, the CAD patients had significantly reduced Sa?Ea and Ea/Aa ratio of each of 6 mitral annulus site, especially the CAD with MI patients, although no systolic dysfunction was found by the conventional echocardiography in CAD patients without MI and no significant differences were observed between the control group and the CAD with or without MI group in terms of E/A ratio and S/D ratio. 2?In patients with CAD, there were close relations between the 6-site average Sa of the mitral annulus and LVEF( r=0.746, P <0.001). Conclusion: The 6-site velocities of mitral annulns can quantitatively assess the left ventricular function in patients with CAD. They are more sensitive than the conventional echocardiography and may be helpful for the early diagnosis.