组织多普勒显像与冠脉造影对缺血心肌舒张功能的评价

目的本文与冠状动脉造影对照研究组织多普勒显像（TDI）技术评估缺血心肌局部舒张功能的价值。方法超声心动图记录心肌缺血（Is,28例）和志愿者（Con,30例）舒张期二尖瓣血流频谱（TMF）及左室基底部,中部和心尖部三个水平面15节段TDI。结果两组间左室射血分值相近;Is组TMF舒张早期减速度时间和等容舒张时间延长（P<0.01）;E/A比值增加（P<0.01）;Con组TDI示左室基底部与中部心肌舒张早期舒张速度（mE）高于心尖部（P<0.05）,缺血节段mE降低,局部早期舒张减速度时间和等容舒张时间延长;Is组异常显示率TDI高于TMF（93％64％,P<0.01）。结论TDI可无创检测左室局部舒张功能,其异常显示率高于TMF

Evaluation of regional diastolic function in ischemic myocardium with tissue doppler imaging and angiography of coronary artery

Objective We evaluated the ability of tissue Doppler imaging(TDI), a new echocardiographic techique that can image the regional myocardial velocity, to assess the regional diastolic function in ischemic heart disease. Methods Control subjects (Con,30 cases)and patients with ischemic heart diseases(IS,28 cases)were enrolled.Global and regional isovalumic relaxation time(IRT,mIRT),deceletation time of early filling (DcT, mDcT),early diastolic velocity(E,mE), late diastolic velocity (A, mA),E/A and mE/mA were measured by pulsed Doppler echocardiography and TDI respectively. Results There were not difference in LVEF between Is and Con groups. Compared with Con, DcT and IRT were prolonged ( P <0.001) in Is group respectively. The mE in basal and middle level of left ventricle were higher than those in apical level in Con group. The slower mE, longer mIRT and rmDcT were found in Is segments. Compared to diastolic transmitral flow,TDI showed higher abnormal rate in Is group(64% vs 93%, P <0.01). Conclutions TDI can non invasive evaluate of regional diastolic function in ischemic myocardium,which showed abnormal relaxation pattern and more sensitive than TMF.