Tei指数评价冠脉旁路移植术前后左室整体心功能变化

目的应用Tei指数评价冠脉旁路移植术(CABG)前后患者整体心室功能的变化.方法34例行CABG手术的冠心病患者根据术前LVEF测值分为A组(EF正常组)和B组(EF低下组),分别于术前、术后2～4周、3个月、6个月,应用Tei指数、左室射血分数(LVEF)和二尖瓣血流图检测左室整体心功能.结果术前,A、B两组Tei指数均较正常增高,且B组显著高于A组(P＜0.01).术后,两组Tei指数均逐渐下降,与术前比较以及术后各时间点间比较差异显著(P＜0.05或0.01),且术后不同时间点两组间比较差异显著(P＜0.01).采用LVEF和二尖瓣血流图评价时,术前A、B两组间均存在显著差异(P＜0.05);术后A组LVEF较术前增高不显著(P＞0.05),但E/A较术前明显增高(P＜0.01);B组LVEF较术前明显增高(P＜0.05),E/A早期减低,术后3个月至6个月逐渐升高.结论Tei指数综合考虑心室收缩和舒张功能,能较LVEF和E/A更准确地评价CABG前后患者整体心功能的变化.

Changes of left ventricular function prior and post to coronary artery bypass surgery: an evaluation by Tei index

Objective To investigate the value of Tei index in evaluating global left ventricular (LV) function changes in patients receiving coronary artery bypass grafting (CABG). Methods Thirty-four patients who underwent CABG surgery were enrolled. According to the LVEF (left ventricular ejection fraction, measured by Simpson's method), the patients were grouped into A (normal EF) and B (decreased EF). Tei index, left ventricular ejection fraction (LVEF) and mitral inflow were acquired by echocardiography before and 2-4 week, 3 months and 6 months after CABG. Results Before surgery, Tei index of the two groups were both increased (abnomal), while the increase was more significant in group B than in group A (P<0.01). After surgery, Tei index of both groups decreased gradually. Between prior and post to CABG and at all time points after CABG. There were significant differences (P<0.05 or P<0.01) in both the groups. Moreover, between the two groups, there were significant differences at all time points post-surgery (P<0.01). When evaluated using LVEF and mitral spectral, these patients showed significant difference between two groups before surgery (P<0.05). After surgery, LVEF of group A increased non-significantly (P>0.05) and E/A ratio increased gradually and significantly (P<0.01) when compared with pre-surgery. LVEF of group B increased significantly (P<0.05) and E/A ratio decreased at first time point (2-4 weeks post-surgery) and then increased gradually (form 3 to 6 months post-surgery). Conclusion Tei index evaluates systolic and diastolic heart function comprehensively and assessed the global LV function change more accurately than LVEF and E/A in our study.