定量组织多普勒对主动脉瓣硬化左室舒张功能的评价

目的:应用定量组织多普勒速度成像(QTVI)技术探测二尖瓣环舒张早、晚期运动速度,评价主动脉瓣硬化(AVS)病人左室舒张功能。方法:选择主动脉瓣硬化无主动脉瓣狭窄54例,主动脉瓣硬化伴主动脉瓣狭窄38例,正常对照组43例。取标准心尖四腔观,采用QTVI测定二尖瓣环侧壁段舒张早期最大运动速率(Em)、舒张晚期最大运动速率(Am);应用脉冲波多普勒测量二尖瓣口舒张早期最大流速曲线(E)和舒张晚期最大流速曲线(A)。结果:主动脉瓣硬化伴主动脉瓣狭窄组Em、Am均低于正常对照组和主动脉瓣硬化无主动脉瓣狭窄组(P<0.05),E、A均高于正常对照组和主动脉瓣硬化无主动脉瓣狭窄组(P<0.05);主动脉瓣硬化无主动脉瓣狭窄组与正常对照组相比,Em降低(P=0.015)、A明显升高(P<0.001);E、Am无显著性差异(P>0.05)。结论:主动脉瓣硬化患者左室舒张功能下降,组织多普勒较血流脉冲频谱多普勒更能敏感、精确地反映主动脉瓣硬化尤其是主动脉瓣硬化伴主动脉瓣狭窄患者的左室舒张功能改变。

Assessment of left ventricular diastolic function in patients with aortic valve sclerosis by quantitative tissue Doppler imaging

Objective:To assess the left ventricular relaxation abnormalities in patients with aortic valve sclerosis(AVS) by quantitative tissue velocity imaging(QTVI).Methods:Doppler echocardiography and QTVI were performed in AVS with valvular aortic stenosis(n=38),AVS without valvular aortic stenosis(n=54) and healthy subjects(n=43) at annular level in apical four chamber view.Transmitral inflow peak velocities during early diastole(Em) and late diastolic(Am) were measured.Transmitral inflow peak velocities during early diastole(E) and late diastole(A) by pulsed Doppler were also mearsured as reference.Results:Em and Am of AVS with valvular aortic stenosis were lower than that of healthy subjects and that of AVS without valvular aortic stenosis(P<0.05),E and A of AVS with valvular aortic stenosis were higher than that of healthy subjects and that of AVS without valvular aortic stenosis(P<0.05);Em between AVS without valvular aortic stenosis and healthy subjects were different(P=0.015),while A between them was significantly different(P<0.001).But there were no differences of E and Am between them.Conclusion:Left ventricular relaxation decreased in AVS,QTVI is more sensitive and accurate than conventional Doppler imaging for evaluating diastolic properties in AVS especially with valvular aortic stenosis.