多普勒组织成像测定二尖瓣环运动速度评价急性心肌梗死后患者左心室功能

目的 :应用多普勒组织成像 (DTI)技术测定二尖瓣环运动速度 ,定量分析急性心肌梗死后患者左心室收缩和舒张功能。方法 :研究对象为 6 1例确诊首次急性心肌梗死的患者和 2 0例正常人。常规行超声心动图检查及DTI技术测定二尖瓣环运动速度频谱。记录心尖四腔、心尖二腔和心尖长轴切面多普勒组织成像二尖瓣环运动速度。测定二尖瓣环运动速度参数包括 :二尖瓣环收缩速度 (Sm) ,二尖瓣环舒张早期速度 (Em) ,二尖瓣环舒张晚期速度 (Am) ,二尖瓣环舒张早期速度的比值 (E Em)。结果 :与对照组相比 ,急性心肌梗死后患者DTI可敏感地显示出二尖瓣环收缩和舒张运动速度显著下降(P <0 0 5 ) ;E Em也有显著差别 (P =0 0 13)。DTI二尖瓣环收缩速度与二尖瓣环舒张早期速度之间 ,二尖瓣环收缩速度与左心室射血分数和室壁运动积分之间存在显著的相关性。平均二尖瓣环收缩期速度≥ 8 9cm s预测射血分数 (EF)≥ 5 5 %的敏感性、特异性分别为 88 2 %、70 % ,准确率为 81 5 %。结论 :DTI测量二尖瓣环运动速度 ,作为定量检测急性心肌梗死患者近期心脏功能状态的新方法 ,具有一定的应用价值。

The significant of mitral annulus velocities in evaluating left ventricular function in patients with acute myocardial infarction

Objective:To quantitatively analyze left ventricular systolic and diastolic function after acute myocardial infarction by mitral annulus Doppler tissue imaging. Method: Echocardiography with Mitral annulus Doppler tissue imaging was performed in 61 patients with AMI and 20 control participants. The peak velocities of mitral annulus movement in systolic(Sm) and early diastolic (Em) and late diastolic (Am) phase were obtained. Also the ratio of mitral velocity to early diastolic velocity of the mitral annulus (E/Em ). Result: Compared with controls Sm and Em of AMI group were significantly lower in AMI patients (P<0.05). E/Em were significantly different in two groups (P=0013). Sm correlated with Em, LVEF and Wall Motion Index. Using Sm≥8.9 cm/ s as a cutoff to predict LVEF ≥55 %, the sensitivity ,specificity and accuracy were 88 2 % , 70 % and 81 5% respectively. Conclusion: Mitral annulus Doppler tissue imaging can quantitatively evaluate the left ventricular systolic and diastolic function in patients after acute myocardial infraction.