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组织多普勒成像联合Tei指数评价冠心病患者右心室功能
引用本文:袁文利,万征,黄灿亮,周贵明,于雪芳.组织多普勒成像联合Tei指数评价冠心病患者右心室功能[J].中华超声影像学杂志,2008,17(4).
作者姓名:袁文利  万征  黄灿亮  周贵明  于雪芳
作者单位:天津医科大学总医院心内科,300052
摘    要:目的 探讨组织多普勒成像(tissue Doppler imaging,TDI)技术评价冠心病患者右心室功能的价值.方法 120例行冠状动脉造影(CAG)者为研究对象,根据CAG、病史、症状、心电图、心肌酶等临床证据分为三组:对照组40例,冠状动脉狭窄<50%;心绞痛组40例,至少一支主要冠状动脉狭窄≥70 %;急性心肌梗死组40例.脉冲多普勒测量右室Tei指数(PW-Tei);TDI分别测量三尖瓣环室间隔部和右室侧壁部Tei指数(TDITei)及收缩期S波峰值速度(sa)、舒张早期E波峰值速度(Ea)、舒张晚期A波峰值速度(Aa),计算Ea/Aa.结果 ①对照组、心绞痛组、心肌梗死组右室的PW-Tei和TDI-Tei逐渐升高,三组PW-Tei分别为0.363±0.086,0.463±0.078,0.569±0.066;三组TDI-Tei(三尖瓣环两部位均值)分别为0.400±0.058,0.520±0.078,0.628±0.059;三组间Ea和Ea/Aa逐渐减低;Sa在对照组和心绞痛组之间差异无统计学意义,心肌梗死组低于对照组和心绞痛组;②右室的PW-Tei与三尖瓣环室间隔部、侧壁部的TDI-Tei显著相关(r为0.596和0.776);③三尖瓣环两个不同部位测量的TDI-Tei及速度指标均显著相关(r为0.628~0.767).结论 TDI技术可评价冠心病患者右室功能,TDI-Tei可敏感反映不同类型冠心病患者右室整体功能损害程度.

关 键 词:超声心动描记术  冠状动脉疾病  心室功能  

Assessment of right ventricular function by tissue Doppler imaging and Tei index in patients with coronary artery disease
YUAN Wen-li,WAN Zheng,HUANG Can-liang,ZHOU Gui-ming,YU Xue-fang.Assessment of right ventricular function by tissue Doppler imaging and Tei index in patients with coronary artery disease[J].Chinese Journal of Ultrasonography,2008,17(4).
Authors:YUAN Wen-li  WAN Zheng  HUANG Can-liang  ZHOU Gui-ming  YU Xue-fang
Abstract:Objective To evaluate right ventricular(RV)function by tissue Doppler imaging(TDI)and Tei index in patmnts with coronary artery disease(CAD).Methods One hundred twenty patients who underwent coronary angiography(CAG)were enrolled.Based on clinic evidences,such as CAG,disease history,symptom,ECG,and myocardial enzymes,all patients were divided into three groups:control group,angina group and myocardial infarction(MI)group.TDl was performed on the lateral and septal tricuspid annular.RV Tei index was obtained either from the pulse-wave Doppler(PW-Tel)and from TDI(TDI-Tei).Results There were significant differences in RV PW-Tei,TDI-Tei,Ea,and Ea/Aa among three groups.PW-Tei was 0.363±0.086.0.463±0.078 and 0.569±0.066,and TDI-Tei was 0.400±0.058,0.520±0.078 and 0.628±0.059 for the control group,angina group and MI group,respectively.Ea and Ea/Aa were gradually decreased following the severity of CAD.Sa was no difference between the control group and angina group,while Sa was much lower in mvocardial infarction group than in other groups.RV PW-Tei had a good correlation with the lateral and septal TDI-Tei.The lateral and septal TDI-Tel were significant correlated with motion velocities.Conclusions TDI can be used to comprehensively evaluate RV function in patients with CAD.TDI-Tei can sensitive reflect the damage level of overall RV function in patients with different degree CAD.
Keywords:Echocardiography  Coronary disease  Ventricular function  right
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