应用多普勒组织成像评价冠心病患者左心室舒张功能

目的 :探讨应用多普勒组织成像 （DTI）检测二尖瓣环运动速度评估冠心病左室舒张功能的临床应用价值。方法 :应用 DTI技术 ,对 5 3例冠心病患者和 48例正常对照者二尖瓣环运动速度进行测定 ,并与常规多普勒超声心动图检查结果对照分析。结果 :与正常组相比 ,冠心病患者舒张早期 DTI速度峰值 （Ve）显著减低 （P<0 .0 1） ,舒张早期与舒张晚期 DTI速度峰值的比值 （Ve/ Va）显著减低 （P<0 .0 5 ）。冠心病患者 Ve/ Va比值异常检出率显著高于二尖瓣血流 E/ A比值的异常检出率 （P<0 .0 5 ）。 Ve/ Va比值与 E/ A比值之间存在高度相关性 （P<0 .0 1）。结论 :DTI技术检测二尖瓣环舒张期运动速度参数可用于无创评价冠心病左室舒张功能 ,尤其对鉴别伪正常具有一定应用价值。     

多普勒组织成像评价肥厚型心肌病左室舒张功能

目的应用多普勒组织成像脉冲技术测量二尖瓣环舒张速度,以评价肥厚型心肌病左室舒张功能.方法对90例肥厚型心肌病患者及50例正常人进行常规超声心电图及多普勒组织成像检查,测量各房室内径,室壁厚度,射血分数及二尖瓣环各点舒张早期峰值速度(Ea)、舒张晚期峰值速度(Aa).两组指标比较采用成组t检验.结果肥厚型心肌病患者室间隔厚度(25.5±6.6)mm,左室后壁厚度(9.9±2.3)mm,左室内径(42.9±5.9)mm,左房内径(39.9±4.7)mm,LVEF(71.9±4.3)%,二尖瓣血流E/A为1.42±0.7.肥厚型心肌病患者Ea较正常人减低.Aa无明显差异.结论肥厚型心肌病左室长轴主动松弛功能较正常人减低.     

应用组织多普勒成像技术对高血压病左室舒张功能的评估

目的探求无创评价左室舒张功能的新方法。方法应用组织多普勒成像（DTI）及脉冲多普勒（PWD）技术检测高血压患者二尖瓣环舒张期运动速度（E、A）及二尖瓣口血流频谱（e、a）,并进行对比研究。结果①高血压病患者e、e/a较正常对照组明显降低（P<0.01）,左室等容舒张时间及减速时间显著延长（P<0.01）,但左室肥厚（LVH）组与non-LVH组间无显著差异。②正常人E/A与年龄呈负相关,高血压病患者的相关性减低（P<0.05,P<0.01）。③高血压病患者E、E/A较正常对照组明显减低（P<0.01）,且LVH组比non-LVH组降低更加显著（P<0.01）。④DTI检测左室充盈假性正常化组二尖瓣环E/A<1。结论DTI能更准确地测定高血压病患者二尖瓣环舒张期运动速度的改变,评价左室舒张功能受损程度优于传统的血流多普勒法。     

多普勒组织成像检测肥厚型心肌病与高血压性心脏病的参数比较

目的初步探讨多普勒组织成像技术（TDI）对肥厚型心肌病（HCM）与高血压性心脏病鉴别诊断的临床价值。方法应用TDI技术对HCM患者、高血压性心脏病患者及正常人分别测量二尖瓣环收缩期峰值速度（Vs）、舒张早期峰值速度（Ve）及舒张晚期峰值速度（Va）。常规超声检查测得左室射血分数（LVEF）、左室短轴缩短率（FS）、二尖瓣口血流峰值速度E、A,计算E/A。结果HCM组、高血压性心脏病组各峰值速度均减低,与正常组比较差异有显著性意义（P<0.05）;HCM组部分心肌节段峰值速度与高血压性心脏病组比较有显著性差异（P<0.05）。结论TDI技术对HCM与高血压性心脏病鉴别诊断提供可行、实用的信息。     

多普勒组织成像评价冠心病患者的左室整体收缩功能

目的 :探讨应用多普勒组织成像 （DTI）检测二尖瓣环收缩期运动速度评估冠心病左室整体收缩功能的应用价值。方法 :应用 DTI技术 ,对 5 4例临床确诊 （其中 30例经冠脉造影证实 ）的冠心病患者收缩期二尖瓣环峰值运动速度 （Sa）进行测定 ,并与二维超声心动图 （2 DE）检查结果对照分析。结果 :冠心病患者二尖瓣环 Sa与△ D%及L VEF均呈显着正相关。左室整体收缩功能 （GL VSF）正常组的 Sa显着高于 GL VSF减低组 （P<0 .0 1）。以 Sa≥ 6.8cm/s为标准诊断左室整体收缩功能正常的敏感度、特异度及准确度分别为 74% ,87%和 81%。结论 :DTI技术检测二尖瓣环收缩期运动速度可用于无创评价冠心病左室整体收缩功能。     

组织多普勒对"缘对缘"二尖瓣成形术后左心室舒张功能评价

目的:EMVP技术将脱垂的二尖瓣叶相对应的前后叶缝合起来,形成一个双孔二尖瓣,从而改变了二尖瓣的解剖形态,本文旨在研究组织多普勒在"缘对缘"二尖瓣成形术后左心室舒张功能的作用.方法:30例二尖瓣关闭不全患者根据成形方式被分成A、B组,A组:15例二尖瓣后叶脱垂患者接受后叶楔形切除;B组:15例前叶或双叶脱垂患者接受"缘对缘"二尖瓣成形术,所有患者均同时接受二尖瓣环成形.术前及术后1周,运用彩色多普勒、组织多普勒测定患者左心室舒张功能指标,包括:术前和术后E峰与A峰血流速比值(E/A),舒张期E峰血流速度与舒张早期二尖瓣环的最大运动速度的比值(E/Em), 舒张早期二尖瓣环的最大运动速度与舒张晚期二尖瓣环的最大运动速度的比值(Em/Am).结果:A组与B组成形术后二尖瓣口面积及二尖瓣反流程度均明显减小,E/A、E/Em及Em/Am在手术前后组间及组内之间均无明显变化.结论:组织多普勒能较好客观地评价"缘对缘"二尖瓣成形后左心室舒张功能,"缘对缘"二尖瓣成形技术效果良好,对左心室的舒张功能无明显影响.     

超声组织多普勒应变率与Tei指数对糖尿病前期患者左室舒张功能的评价

目的 应用组织多普勒应变率成像技术(SRI)及Tei指数评价糖尿病前期患者左室局部和整体舒张功能,为早期诊断及治疗糖尿病心肌病变提供依据.方法 选取糖尿病患者35例、糖尿病前期患者30例、对照组35例,组织多普勒(TDI)测算二尖瓣环Ea/Aa及Tei指数.SRI技术测量左室基底段及中间段各壁SRe、SRa及SRe/SRa.结果 ①糖尿病前期组与对照组比较Tei指数明显延长(P＜0.01).②糖尿病前期组左室心肌所有节段SRe均小于对照组,12个节段中11个节段差异有统计学意义(P＜0.05).糖尿病前期组左室心肌12个节段SRe/SRa除了侧壁基底段和中间段2个节段略高于对照组外(P＞0.05),其余10个节段均小于对照组(P＜0.05).③Tei指数与SRe、SRe/SRa呈负相关,相关系数分别为-0.574和-0.374(P＜0.05).结论 糖尿病前期患者的左室局部节段舒张功能已受到损害.将SRI技术结合Tei指数可以更加全面、准确地评价糖尿病前期患者左心室的舒张功能.     

Correlation of Tei index obtained from tissue Doppler echocardiography with invasive measurements of left ventricular performance

BACKGROUND: The aim of this study is to correlate Tei index obtained from tissue Doppler echocardiography (TDE-Tei index) defined as the ratio of the sum of isovolumetric contraction time (ICT) and isovolumetric relaxation time (IRT) over the ejection time (ET) with invasive measurements of left ventricular (LV) performance. METHODS: Thirty-four patients who underwent an echocardiographic examination and cardiac catheterization were studied. Invasive measurements of peak +dp/dt, peak -dp/dt, and isovolumic relaxation constant of the left ventricle (tau) were obtained from a micromanometer-tipped catheter. RESULTS: After a multivariate analysis, TDE-Tei index had a negative correlation with ejection fraction (EF) (beta=-0.384, P = 0.046) and positive correlation with tau (beta= 0.397, P = 0.040). ET had a negative correlation with heart rate (beta=-0.446, P = 0.005) and positive correlation with EF (beta= 0.379, P = 0.015). ICT + IRT had a positive correlation with tau (beta= 0.512, P = 0.002). ICT/ET had a negative correlation with EF (beta=-0.657, P < 0.001) and positive correlation with peak early transmitral filling wave velocity (beta= 0.385, P = 0.001). IRT/ET had a positive correlation with tau (beta= 0.402, P = 0.018). CONCLUSIONS: TDE-Tei index exerts a correlation both with accepted indices of LV systolic and diastolic function acquired by cardiac catheterization. Hence, TDE-Tei index is a simple and feasible indicator in assessing overall LV function.     

多普勒组织成像技术评价急性心肌梗死右心室功能

急性心肌梗死 ( A MI)中右心室发生了一系列病理生理变化。右心室功能对于 A MI的发展及预后有重要意义 ,而右心室功能的评价较为复杂 ,多普勒组织成像 ( DTI)技术的应用为评价右心室功能提供了一种可靠的方法     

多普勒超声对左室舒张压升高的评估作用

目的探讨二尖瓣口血流频谱和瓣环的组织多普勒频谱与左室平均舒张压的关系。方法将79例患者分为正常组、早期舒张功能不全组和假性正常化组,测量其二尖瓣口的血流频谱（E、A、E/A比值和E峰减速时间DT）、二尖瓣环的组织多普勒频谱（s、e、a和e/a比值）、肺静脉血流频谱（PVs、PVd）及E/e。结果与假性正常化组的E/e比值比较,显著高于其它两组（P<0.01）;与假性正常化组的左室平均舒张压（mLVDP）为（12.6±2.8）mmHg比较,显著高于早期舒张功能不全组的左室平均舒张压（6.8±1.7）mmHg（P<0.01）,E/e比值与左室平均舒张压（mLVDP）呈较好的相关性（r=0.83,P<0.01）。结论E/e比值增高对评估mLVDP升高意义较大。     

用多普勒组织显像速度模式评价左心室收缩及舒张功能

目的 :初步评价多普勒组织显像 （DTI）检查左心室收缩和舒张功能的临床应用价值。方法 :用 DTI速度模式检测了正常健康组 114例和左室收缩功能降低 （左室缩短率 FS<2 5 % ）组 40例二尖瓣后叶瓣环位及左室后壁心肌的运动速度。结果 :各参数在正常男女间无显著差异 ,心功能降低组较正常组明显降低 （P<0 .0 1） ;正常组左室后壁心肌收缩速度与 FS间呈正相关 （r=0 .38）。结论 :用 DTI的速度模式检测局部室壁运动速度是评价心室收缩和舒张功能的一种较简便、直观、全面、准确的新方法     

Differentiation of left ventricular diastolic dysfunction, identification of pseudonormal/restrictive mitral inflow pattern and determination of left ventricular filling pressure by Tei index obtained from tissue Doppler echocardiography

BACKGROUND: Tei index obtained from tissue Doppler echocardiography (TDE-Tei index) has an inherent advantage of recording its systolic and diastolic components simultaneously on the same cardiac cycle. The aims of this study are to evaluate whether TDE-Tei index also exerts a correlation with left ventricular (LV) systolic and diastolic function and filling pressure and to see whether it can effectively identify the pseudonormal/restrictive mitral filling pattern. METHODS: Echocardiographic examination was performed in 243 consecutive patients. These patients were classified into three groups as normal, abnormal relaxation, and pseudonormal/restrictive groups according to the transmitral E/A-wave velocity (E/A), early diastolic velocity of lateral mitral annulus (Ea) and E/Ea. RESULTS: Standard Doppler indices of LV filling such as E, A, E/A, and E-wave deceleration time had a bimodal distribution, but Ea decreased and E/Ea and TDE-Tei index increased progressively with worsening of LV diastolic function. The sensitivity and specificity of TDE-Tei index>0.51 in the discrimination of pseudonormal/restrictive filling pattern were 85% and 96%, respectively. After stepwise multiple linear regression analysis, TDE-Tei index had a significant negative correlation with Ea (beta=-0.296, P<0.001) and ejection fraction (beta=-0.293, P<0.001) and positive correlation with E/Ea (beta=0.235, P=0.001). CONCLUSIONS: TDE-Tei index increased with worsening of LV diastolic function and can effectively identify the pseudonormal/restrictive mitral inflow pattern. It also correlated with the echocardiographic parameters of LV systolic and diastolic function and filling pressure. It suggests that TDE-Tei index is a simple and feasible marker in assessing global LV function.     

定量组织速度成像测量二尖瓣环运动速度评价肥厚型心肌病患者左室舒张功能

目的 :应用定量组织速度成像 (QTVI)测量二尖瓣环运动速度评价肥厚型心肌病 (HCM )患者左室舒张功能。方法 :QTVI测量 31例HCM患者 (HCM组 )和 2 0例正常人 (对照组 )二尖瓣环 6个节段 (后间隔和侧壁、前间隔和后壁、前壁和下壁 )舒张早期峰值速度 (Ve)、左房收缩期峰值速度 (Va) ,计算平均Ve、Va和Ve/Va比值。多普勒超声心动图测量二尖瓣口血流快速充盈速度E峰、左房收缩充盈速度A峰 ,计算E/A值和E与平均Ve的比值 (E/Ve)。结果 :HCM患者平均Ve和Ve/Va较对照组明显减低 [(Ve:(3.6 4± 1.4 1)cm/s∶(8.2 1±1.6 9)cm/s,P <0 .0 1;Ve/Va:(0 .92± 0 .5 1)∶(1.5 7± 0 .5 0 ) ,P <0 .0 1;E和E/A较对照组减低 [E :(74 .73±2 6 .5 5 )cm/s∶(84 .0 0± 14 .5 7)cm/s ,P =0 .14 2 ;E/A :(1.12± 0 .4 9)∶(1.6 8± 0 .4 1) ,P <0 .0 1;E/Ve较对照组明显增高 [(2 3.0 3± 7.73)∶(10 .5 3± 2 .6 7) ,P <0 .0 1]。E/A <1者 14例 (4 5 .2 % ) ,Ve/Va <1者 2 0例 (6 4 .5 % ) ;E/A >1的HCM患者其Ve和Ve/Va亦较对照组明显减低 ,E/Ve明显增高。结论 :HCM患者二尖瓣口多普勒血流信号E、A受前负荷和左房收缩性等因素的影响 ,而QTVI测量二尖瓣环运动速度能准确评价HCM患者左室舒张功能。     

Preload dependence of Doppler tissue imaging derived indexes of left ventricular diastolic function

Doppler tissue imaging (DTI) has been proposed as a tool for the evaluation of diastolic function. Controversy exists regarding whether DTI measurements are influenced by preload. Changes in the circulating volume associated with hemodialysis result in preload reduction. To determine the influence of preload reduction on DTI and standard pulsed-Doppler transmitral diastolic velocities, 30 patients (mean age 41 +/- 14) with chronic renal insufficiency without overt heart disease were studied by DTI and standard pulsed Doppler before and after hemodialysis. From the apical window, DTI sample volume was placed at the lateral and septal mitral annulus and at the midsegment of lateral and septal myocardial wall of the left ventricle. Peak early diastolic annular and myocardial, and peak late diastolic annular and myocardial velocities were measured. Transmitral peak early and late diastolic velocities were also recorded by standard pulsed Doppler. The peak velocity of early diastolic mitral flow decreased from 100 +/- 30 to 85 +/- 34 cm/s (P < 0.001) after hemodialysis. Hemodialysis elicited marked reduction in early diastolic lateral mitral annular and midlateral myocardial velocities (6.9 +/- 3.2 to 6.3 +/- 2.9 cm/s, P < 0.04 and 6.7 +/- 0.3 to 5.5 +/- 2 cm/s, P < 0.001, respectively). Early diastolic, septal mitral annular, and midseptal myocardial velocities were also significantly decreased (5.8 +/- 2.8 to 4.6 +/- 2 cm/s, P < 0.006 and 6.2 +/- 2 to 5.1 +/- 1 cm/s, P < 0.008, respectively). Late diastolic mitral annular and myocardial velocities did not change. It is concluded that early diastolic mitral annular and myocardial velocities are affected by acute preload reduction. It is necessary to consider preload when diastolic function is assessed by DTI.     

Effect of obesity on left ventricular structure and myocardial systolic function: assessment by tissue Doppler imaging and strain/strain rate imaging

BACKGROUND: Obesity is associated with heart failure, cardiovascular morbidity, and mortality. A direct effect of weight on left ventricle (LV) structure and myocardial function is not well-established. AIM: The aim of our study is to determine the effect of obesity on LV morphology and systolic function by using LV standard Doppler echocardiographic indices, myocardial Doppler imaging and strain/strain rate imaging indices. METHODS: We studied 33 obese and 34 age, sex-adjusted control subjects who had no other pathological conditions. Standard transthoracic Doppler echocardiographical measurements, reconstructed spectral pulsed wave tissue Doppler velocities, strain and strain rate imaging of six different myocardial regions were obtained. Peak systolic velocity (SR), peak systolic strain (I), peak systolic strain rate (SR) for each region and as a global systolic longitidunal LV function mean of peak systolic strain of six myocardial regions (glsca) were compared. RESULTS: Age, body surface area, blood pressure, and heart rate were comparable between the two groups. Obese subjects had significantly increased LV end-diastolic volume, septal wall thickness, left atrial diameter, and decreased transmitral early to late diastolic velocity ratio. In obese subjects, reconstructed spectral pulsed-wave tissue Doppler analysis showed significantly decreased basal lateral peak systolic (Sm) velocity (6.68 +/- 1.89 vs. 8.08 +/- 2.50, P < 0.05), mid lateral Sm (5.01 +/- 2.17 vs. 6.78 +/- 3.22, P < 0.05). Differences in regional strain rate (mid septal SR, 1.45 +/- 0.23 vs. 1.63 +/- 0.18, P < 0.05), regional strain (basal septum I, 19.13 +/- 3.83 vs. 22.09 +/- 4.60, P < 0.05; mid-septum I, 18.03 +/- 2.91 vs. 20.25 +/- 4.77, P < 0.05; radial I, 27.50 +/- 7.32 vs. 35.53 +/- 9.48, P < 0.05), and global strain (glsca, 19.38 +/- 1.34 vs. 21.24 +/- 2.82, P < 0.05) were identified between obese and the referent subjects. CONCLUSIONS: Obesity is associated with morphologic alterations in left ventricle and left atrium and subclinical changes in left ventricle systolic function which can be detected by strain and strain rate imaging even without overt heart disease.     

脉冲组织多普勒成像技术检测糖尿病患者左室舒张功能

目的应用脉冲组织多普勒成像技术(PWDTI)检测糖尿病(DM)组和健康对照组左室舒张功能,并与传统二尖瓣血流频谱E/A比较。方法用PWDTI在心尖左室长轴水平二尖瓣环后壁处测量舒张期E峰速度(Ve)、A峰速度(Va),计算Ve/Va比值;在同一切面用彩色多普勒血流显像技术(CDFI)测量二尖瓣口舒张期血流频谱E峰、A峰值,计算E/A比值,并计算E/Ve比值。DM组根据尿蛋白阴性或阳性分为两亚组,并根据糖化血红蛋白(HbA1c)浓度≤或>7%分为两亚组。结果DM组和健康对照组Ve/Va比值[(0.87±0.37)、(1.21±0.4)]以及E/Ve比值[(9.24±4.47)、(6.03±1.72)]差异有统计学意义(P<0.05)。DM组尿蛋白阴性、阳性亚组的E/Ve比值分别为(7.36±2.46)、(10.5±2.49),DM组HbA1c≤7%和>7%亚组E/A比值分别为(0.64±0.24)、(1.32±0.22),两亚组比较均差异有统计学意义(P<0.05)。结论PWDTI观测DM左室舒张功能较传统二尖瓣口血流频谱E/A具有明显的优越性,两者结合起来能更好地反映左室舒张功能。     

Evidence of left ventricular systolic and diastolic dysfunction by color tissue Doppler imaging despite normal ejection fraction in patients on chronic hemodialysis program

Background: Cardiovascular diseases are responsible for about half of deaths and are the major cause of mortality in hemodialysis patients. The aim of this study is to assess left ventricular (LV) longitudinal myocardial functions by color tissue Doppler imaging (TDI) in patients with chronic renal failure on a regular hemodialysis program. Methods: Thirty-one patients on a regular hemodialysis program (mean age 47 ± 12 years; 17 males, 14 females) were included into the study. Twenty-three healthy subjects (mean age 44 ± 8 years; 15 males, 8 females) were studied as a control group. The patients had been on maintenance hemodialysis for at least 1 month and hemodialysis sessions were three times per week. For color TDI, apical two- and four-chamber views of left ventricle were used. Sample volumes were placed on the mid-left ventricle in the inner half of the myocardium at the septum, lateral, inferior, and anterior walls. Peak LV strain, peak systolic strain rate, peak early diastolic strain rate, peak late diastolic strain rate, peak systolic tissue velocity, peak early diastolic tissue velocity, and peak late diastolic tissue velocity values were measured. Results: Mean peak LV strain, mean peak systolic strain rate, and mean peak systolic tissue velocity values were all lower in the hemodialysis group. Although mean peak late diastolic strain rate and mean peak late diastolic tissue velocity values were similar between the groups, mean peak early diastolic strain rate and mean peak early diastolic tissue velocity values were lower in the hemodialysis group. Conclusion: Patients with chronic renal failure on regular hemodialysis program show significant alterations at LV longitudinal myocardial function parameters assessed by color TDI.     

组织多普勒评价原发性高血压不同左心室构型患者右心室舒张功能

目的:应用多普勒组织成像(DTI)技术检测原发性高血压(EH)不同左心室构型患者三尖瓣环脉冲组织多普勒(PW-DTI)频谱,评价其右心室舒张功能.方法:EH患者80例,按照Ganau分类方法,以左心室质量指数(LVMI)和相对室壁厚度(RWT)分为:正常左心室构型组(EH1组),向心性重构组(EH2组),向心性肥厚组(EH 3组)及离心性肥厚组(EH 4组);另入选20例健康体检者作为正常对照组.取标准心尖四腔切面,用PW-DTI技术测量各组的三尖瓣瓣环舒张早期峰值速度(E),舒张晚期峰值速度(A)及E/A值.结果:与正常对照组比较:EH1、2、3、4组E峰逐渐减低,A峰逐渐增高,E/A比值逐渐减低(P<0.05);EH各组间比较:平均E峰逐渐减低且随左心室构型改变呈下降趋势(P<0.05);平均A峰逐渐增高且随左心室构型改变呈上升趋势(P<0.05).结论:①EH患者早期左心室构型正常时已存在右心室舒张功能减低;②EH患者的右心室舒张功能在不同左心室构型中根据恶化程度呈下降趋势;③DTI技术可用于评价EH患者右心室舒张功能.     

组织多普勒成像评价血压昼夜节律变异对左心室舒张功能的影响

目的探讨血压昼夜节律变异对左心室舒张功能的影响。方法31例非杓型高血压患者(非杓型组)和31例年龄、性别相匹配的杓型高血压患者(杓型组)入选。两组患者均行24 h动态血压监测和组织多普勒成像(DTI)检查。结果两组日间平均收缩压和平均舒张压无显著性差异,非杓型组的夜间平均收缩压和平均舒张压均显著高于杓型组[(145.1±34.5)mm Hg(1 mm Hg=0.133 kPa)vs(127.9±18.1)mm Hg,(94.2±38.1)mm Hgvs(78.5±18.2)mm Hg,P<0.05]。心脏超声检查显示两组在心腔内径、室壁厚度和左心室射血分数等参数无显著性差异,DTI结果显示非杓型组的平均组织舒张早期速度(MEa)、MEa/平均组织舒张晚期速度(MAa)显著低于杓型组[(5.9±2.1)cm/svs(7.8±3.1)cm/s,(0.68±0.56)cm/svs(0.95±0.39)cm/s,P<0.05和P<0.01)];非杓型组的MAa较杓型组明显升高[(9.5±2.8)cm/svs(8.6±1.7)cm/s,P<0.01]。结论血压昼夜节律变异可加重左心室舒张功能受损。对于存在血压昼夜节律变异的高血压患者应尽早诊断,积极治疗和加强随访。     

组织多普勒室壁运动时间对肺动脉高压患者右室功能的评价

目的：利用脉冲组织多普勒技术（PW—TDI）测量右室室壁运动时间间期评价肺动脉高压（PH）患者右心功能的变化。方法：PH患者150例,根据PH的程度分为轻度组、中度组、重度组,每组50例,应用PW-TDI测量心尖四腔心切面三尖瓣前瓣瓣环心肌运动的时间间期指标包括：电一机械时间（EMD）、射血前期（PEP）、等容收缩时间（ICT）、心室射血时间（ET）、等容舒张时间（IRT）、充盈时间（FT）,计算Tei指数。将PH组与正常对照组的心肌运动时间间期参数进行比较,通过统计分析了解不同程度PH患者右心功能变化。结果：与正常对照组比较,轻度组IRT延长（P〈0．01）;中度组IRT延长、fvr缩短（均P〈0．01）;重度组IRT、ICT和PEP延长、ET和丌缩短（均P〈0．01）。Tei指数在PH组均增大（均P〈0．01）。中度组较轻度组、重度组较轻度组、重度组较中度组IRT延长、FT缩短（均P〈0．05）;重度组较轻度组ICT和PEP延长、ET缩短、Tei指数增大（均P〈0．05）。EMD在不同水平PH组和正常对照组间无显著性差异。结论：PH导致右室收缩和舒张功能降低,舒张功能降低早于收缩功能降低。