组织多普勒成像和血流多普勒频谱研究冠心病患者左室舒张功能

目的：将组织多普勒成像（TDI）和彩色多普勒超声技术结合研究冠心病虱的左室舒张功能（LVDF）。方法：在心尖四腔心切面上用彩色多普勒超声检测80例心病患和79例相同年龄组正常人舒张早、晚期二尖瓣口血流频谱的最大速度（Vmax)时间速度积分（TVI）,同时用TDI技术检测左室外侧壁心肌收缩、舒张期运动频谱的Vmax和TVI,所有数据进行统计学分析。结果：两种技术所检测的正常人舒张早期峰的Vmax和TVI随着年龄的增长而降低,而舒张晚期峰的Vmax和TVI逐渐增高,冠心病患的数据变化与年龄关系不明显,主要与其心肌的病理变化程度有关,当二尖瓣口血流频谱出现“假性正常”、无法准确判断LVDF时,TDI技术的敏感性较高,它还可按检查的设计任意测量某一部位的心肌运动。结论：用血流多普勒频谱判断LVDF在一般情况下简单、方便。TDI技术可同时对左室收缩、舒张功能进行全面判断。

Study on left ventricular diastolic function in the patients with coronary artery disease by tissue Doppler imaging and color Doppler echocardiography

Objective: To study left ventricular diastolic function (LVDF) in patients with coronary artery disease(CAD) by tissue Doppler imaging (TDI) and color Doppler echocardiography. Methods: The maximum velocity ( V max ) and time velocity integration(TVI) in early and late diastolic stage of mitral valve orifice of 80 patients with CAD and 79 normal subjects were measured by color Doppler echocardiography at apical 4 chamber view. Meanwhile, the V max and/or TVI of the myocardial motion spectrum of left ventricular lateral wall near the mitral valve annulet were measured by TDI. These data were compared and analysed by statistical method. Results: In the normal subjects, the older the subject, the lower the V max and TVI of early diastolic stage, the higher the V max and TVI of late diastolic stage. In CAD group, changes were not associated with ages and were affected by the degree of the myocardial pathology. The LVDF couldn't be exactly judged by color Doppler echocardiography when pseudonormalization blood flow spectrum appeared, but TDI technique was relatively sensitive. Any regional myocardial motion could be measured by TDI according to the examiner's design. Conclusion: LVDF by color Doppler echocardiography is simple and convenient. TDI technique can be used for determining overall LVDF and left ventricular systolic function. [