心脏彩超对冠状动脉慢血流患者左室舒张功能的评价

目的 利用脉冲多普勒组织成像技术(DTI)评价冠脉造影正常者及冠状动脉慢血流(CSF)患者左心室功能.方法 采用矫正TIMI帧计数法(CTFC),按CTFC大于冠状动脉正常血流速度的两个标准差诊断为CSF,将入选病例分为两组:CSF组46例及对照组46例.所有患者术前常规行心脏多普勒超声检查,测定其左心室收缩舒张功能指数.结果 CSF组与对照组比较,左室收缩末期内径(LVEDD)、左室舒张末期内径(LVESD)、射血分数(EF)无统计学差异,左室舒张早期的血流峰值速度E峰下降,左室舒张晚期的血流峰值速度A峰升高,E/A比值下降,E/A比值减低患者出现CSF的比例增高(P＜0.05).结论 E/A比值与CSF密切相关,左室舒张功能障碍在CSF组更明显,DTI对评估CSF患者左心室舒张功能有重要的应用价值.

Evaluation of left ventricular diastolic function in patients with coronary slow flow by heart color ultrasound

Objective To evaluate the left ventricular diastolic function in people with normal coronary angiography and in patients with coronary slow flow（CSF）by Doppler tissue imaging（DTI）.Methods The selected cases were divided into two groups by the method of correct TIMI frame count（CTFC）.Those with two standard deviations of CTFC larger than the normal coronary blood flow rate were diagnosed CSF.There were respectively 46 cases in both CSF group and the control group.All the patients received routine heart Doppler ultrasonic examination before the operation.And the left ventricular systolic and diastolic function indexes were detected.Results There was no significant difference in the left ventricular end-diastolic dimension（LVEDD）,the left ventricular end-systolic dimension（LVESD）and the ejection fraction（EF）between the two groups.In the CSF group,the E peak of blood flow peak velocity in the left ventricular early diastole stage decreased,and the A peak in the left ventricular late diastole stage increased.The ratio of E to A decreased.The lower the ratio of E to A in people,the higher the risk of CSF（P0.05）.Conclusion The ratio of E to A is closely related to CSF.The left ventricular diastolic dysfunction is obvious in the CSF group.DTI is valuable in the evaluation of the left ventricular diastolic function in patients with CSF.