超声测定二尖瓣环运动评价心室舒张功能

目的利用M型超声测定二尖瓣环运动(MAM)评价左室舒张功能。方法陈旧性心梗(OMI)及正常人各35例，记录二尖瓣环舒张早期和晚期M型运动曲线的下降幅度(EM、AM)和斜率(SM、SA)及二尖瓣口血流频谱。结果OMI组的EM明显降低(5.61±1.32vs8.82±1.75，P<0.001)，SE下降(43.12±14.10vs73.92±21.44，P<0.001)，EM/AM低(1.06±0.358vs1.67±0.44,P<0.001)，EM及EM/AM与多普勒血流参数E/A具有相关(r=0.679，P<0.001，r=0.638，P<0.001)，以EM<6.93为标准判断有无舒张功能不全的敏感性和特异性分别为97.14%和91.43%。结论MAM方法适用于无创评估OMI患者的左室舒张功能。

M-mode Analysis of Mitral Annulus Motion for Detection of Diastolic Functionin Patients with Old Myocardial Infarction

Objective To define the role of mitral annulus motion (MAM) for detecting diastolic function in patientswith old myocardial infarction. Methods Echocardiography were performed in 35 patients with myocardial infarction and35 normal participants. The amplitude of early diastolic motion ( EM) and later diastolic motion (AM) ,slope E (SE) ,slopeA (SA) of the septal mitral annulus were derived from M-mode analysis , the mitral inflow pattern were also obtained bypulsed Doppler. Results In the group with OMI , a significant reduction of EM (5. 61 ±1.32 vs 8.82 ±1.75 , P < 0. 001)and SE (43.12 ±14.10 vs 73.92 ±21.4 , P < 0.001) were detected. EM/ AM decreased (1.06 ±0.36 vs 1.67 ±0.44 ,P < 0.001) . Using EM < 6.93 mm as a cut points ,sensitivity and specifivity for the detection of diastolic dysfunction were97.14 % and 91.43 % respectively. There were significant relation between E/ A and EM ( r = 0.679 , P < 0.01) ,SE ( r =0.604 , P < 0.01) ,EM/ AM ( r = 0.638 , P < 0.01) . Conclusion MAM may be a useful tool for assessing LV diastolicdysfunction in patients with OMI.