舒张早期心内充盈减射评价左室舒张功能研究

目的：探讨应用超声心动图测量心室内舒张早期心内充盈减射评价左室舒张功能。方法：连续观察92例受检者,其中正常者19例,高血压患者26例,冠心病47例（其中A／E＞132例）;A／E＜110例;房颤5例）,将脉冲多普勒取样容积置于二尖瓣口及离瓣口1cm、2cm、3cm分别记录心内舒张早期二尖瓣口及离瓣口1cm、2cm、3cm舒张期血流速度,测量En(n=1,2,3)峰值速度计算En与E0比值及二尖瓣口舒张期血流频谱Ao/E0比值。结果：左室舒张早期血流速度在高血压和冠心病组从二尖瓣口至心尖逐渐减低,高血压和冠心病（A／E＞1,A／E＜1,Af）组舒张期心内充盈减射E3及E3／E0比值与E0及E1／E0比值存在差异（P＜0．05）。同时E3／E0舒张功能参数与传统二尖瓣口A0／E0比值存在线性相关（r＝－0．83,P＜0．001）。结论：因此上述超声心动图指标方法可用于评价左室舒张功能,心内充盈减射E3／E0可用于传统指标评价左室舒张功能受限制A／E＜1“假正常”及房颤患者。

Intraventricular Dispersion of Early Diastolic Filling in Assessment of Left Ventricular Diastolic Function by Doppler Echocardiography

Objective:The intraventricular dispersion in peak early diastolic flow velocity was determined to assess left ventricular diastolic function by Doppler echocardiography.Methods:Ninety two consecutive observed subjects,including 19 healthy,26 with hypertension and 47 with coronary artery disease(CAD),32 cases,A/E>1;10case A/E<1; 5 case Af were divided into five groups.Doppler echocardiography studies were obtained from mitral tip toward the apex(E 0,E 1,E 2,and E 3):that is,mitral flow velocity(E 0)and the intraventricular regional early diastolic flow velocity at 1cm,2cm,3cm,from mitral tip toward the apex.Results:The results showed that intraventricular dispersion of early diastolic filling were significantly lower in hyprtensive and CAD subjects than those in healthy ones( P <0 05, P <0 001,respectively).The early regional peak diastolic flow velocity were progressively decreased from the tip toward the apex in patients with hypertension and with CAD.In early regional peak diastolic flow velocity,E 3 and E 3/E 0 ratio were progressively and significantly lower than E 0 and E 1/E 0 ratio( P <0 05).Moreover,there was a close correlation between the E 3/E 0 ratio of the subjects examined and Ao/E 0 ratio by pulsed Doppler( r =-0 83, P <0 001).Conclusions:The intraventricular dispersion of peak early diastolic flow velocity may be useful in detecting LV diastolic dysfunction,particulary in patients with Af or "normalized"mitral velocity pattern and with auricular fibrillation.