定量组织速度成像技术评价急性心肌梗死后左室重构的左室功能

目的应用定量组织速度成像技术对心肌梗死后左室重构的左心功能进行评价,以探讨其应用价值.方法用定量组织速度成像技术测定22例健康者及临床确诊的29例心肌梗死后左室重构的冠心病患者的左室壁各节段的收缩期峰值速度(VS),舒张早期速度(VE),舒张晚期速度(VA)和VE/VA比值.测定二尖瓣口血流频谱的快速充盈速度(E),左房收缩充盈速度(A)和E/A值.容积法测左室射血分数,左室舒张末期容积指数(LVEDVI),左室收缩末期容积指数(LVESVI)及球形指数,并与正常组比较.结果心脏左室长轴方向上心梗组前壁,侧壁,下壁各节段,后间隔心尖段Vs明显下降(P＜0.01),后间隔基底段和中间段Vs无明显差异(P＞0.05);心梗组几乎各节段VE、VA、VE/VA与正常组相比有显著差异(P＜0.05).各节段平均VS与左室射血分数,球形指数等呈线性相关(r值分别为0.79,0.68,P＜0.01),舒张期功能参数平均VE/VA与二尖瓣E/A比值之间存在高度相关性(r=0.62,P＜0.01).心梗组LVEDVI和LVESVI明显增大(P＜0.01).结论定量组织速度成像可客观定位定量的反映心肌梗死局部心肌组织的收缩及舒张功能,又能体现心肌梗死后左室重构的整体功能,为心肌梗死后左室重构的心功能的评价提供了客观依据.     

超声心动图评价高血压病患者左心功能

目的运用超声心动图技术综合评价高血压病患者左室收缩功能和舒张功能。方法高血压病组56例和对照组36例,M-型和二维(2D)超声心动图检测:左房内径(LAd),舒张期室间隔厚度(IVST)和左室后壁厚度(PWT),左室舒张末期内径(LVDd),二尖瓣EF斜率,室间隔及左室后壁运动幅度,左室射血分数(EF),左室短轴缩短率(FS),每搏量(SV);脉冲多普勒(PW)检测二尖瓣口舒张早期充盈峰速度(VE),舒张晚期充盈峰速度(VA),E/A比值,等容舒张时间(IVRT)。结果高血压病患者左室壁与室间隔收缩期运动幅度普遍增强,与对照组比较P<0.01;左室收缩功能各项参数(EF、FS、SV)高于对照组(P<0.05),高血压病组左室舒张功能各参数异常,表现为VE减低,VA升高,E/A<1,IVRT延长,MV-EF斜率减慢,与对照组比较P<0.001;左房扩大(P<0.001)。结论超声心动图技术可反映高血压病患者左心结构和功能变化,为临床诊治提供客观依据。     

彩色血流传播速度对二尖瓣置换术后左心室舒张功能的定量评估

目的 探讨彩色M型多普勒(CMM)评价二尖瓣置换术(MVR)后患者左室舒张功能的临床价值.方法 52例接受MVR术后3个月以上患者为病例组,另选取年龄、性别相匹配的30例正常人为对照组.测量左房室腔大小、机械瓣口流速、射血分数(EF)等常规超声心动图指标;应用CMM测量舒张期左室内彩色血流传播速度(Vp),计算二尖瓣位机械瓣口血流速度(E)与Vp比值(E/Vp);应用组织多普勒测量二尖瓣环舒张期峰值速度(Em),计算均值Em'和E/Em'.结果 ①MVR组Vp、Em较对照组明显减低,E/Vp、E/Em'较对照组明显增高,差异有统计学意义(P<0.001).E/Vp与E/Em'相关性良好,r=0.86,P <0.01;②Vp受左窜收缩功能和心律的影响,当EF≤50%或者心房颤动时,Vp减低更明显(P<0.01),而E/Vp受EF及心房颤动的影响较小(P>0.05);③绘制ROC曲线,以E/Vp≥2.00为最佳截断值,预测E/Em'≥15的敏感性为92.31%,特异性为83.65%,曲线下面积0.954.结论 CMM可用于评价MVR术后左室舒张功能;E/Vp与E/Em具有良好的一致性,可作为评价MVR术后左室舒张功能的有效指标.     

健康人左室质量与舒张功能的关系

目的：探讨健康人左室质量与左室舒张功能的关系。方法：随机选取健康教师320名，行彩色多普勒超声心动图检查，结果：相关分析显示：伴随左室质量的增加E波的峰值速度下降，A波的峰值增加，二者比值下降，等容松驰时间延长，肺静脉收缩波峰值与舒峰值之比增加，但多元回归显示年龄增长、心率加快、体重指数大、血压高和男性是舒张功能减退的独立因素，左室质量指数进入多元回归方程，结论：决定健康人左室舒张功能的因素是年龄、心率、体重指数，血压和性别而不是左室质量。     

Assessment of left ventricular diastolic function from mitral annulus motion,a comparison with pulsed Doppler measurements in patients with heart failure

Summary. Mitral and pulmonary venous flow velocity recordings are often used for the assessment of left ventricular diastolic function. These curves are, however, also influenced by other factors. To investigate whether mitral annulus motion carries additional information in this context, mitral annulus motion was compared to Doppler registrations of mitral and pulmonary flow velocities in 38 patients with heart failure (NYHA II—III) after myocardial infarction. Patients with an increased atrial contribution to mitral annulus motion (> 57%, n= 12) had a higher mitral late-to-early flow velocity ratio (A/E) and pulmonary systolic to diastolic filling ratio (<0–01). Patients with atrial displacement above average for the group (? 5.1 mm, n= 19) had a higher mitral AVE ratio and pulmonary systolic to diastolic filling ratio than patients with a lower than average atrial component (P < 0.05). There was a significant correlation between a/T ratio and A/E ratio (r= 0.61, P < 0.001) and between pulmonary flow and transmitral flow (= 0.76, P < 0.001). We conclude that an increased atrial displacement of the mitral annulus is a frequent finding in patients with signs of left ventricular relaxation abnormality. There is a significant correlation between a/T ratio and A/E ratio but the information contained in the two indices are not identical.     

严重器质性二尖瓣反流患者肺动脉压的预测因素

目的 探讨严重器质性二尖瓣反流患者肺动脉收缩压(PASA)升高的预测因素及与左右心室收缩、舒张功能的关系.方法 二尖瓣脱垂或连枷样引起的中-重度二尖瓣反流患者694例,男361例,女333例,年龄17～57岁,均行常规超声心动图检查并行组织多普勒(TDI)分析,根据三尖瓣反流速度测算PASP;合并EF%<55%及原发性肺动脉高压患者予以排除.根据PASA数值由低至高分成四组,作相关因素分析比较.结果 PASP平均为(40±15)mmHg,与年龄(r=0.36,P<0.01)、MR(r=0.30,P<0.01)、二尖瓣瓣环E/E(侧壁,r=0.40,P<0.01;室间隔,r=0.41,P<0.01)、左心房内径指数(r=0.50,P<0.01)、右心室内经指数(r=0.30,P<0.01)、左心室及右心室舒张功能参数均有很好的相关性,这些变量随PASP的增加而增加;PASP与二尖瓣瓣环TDI收缩期速度、左心室射血分数、左心室短轴缩短率的相关性则较差.多变量分析结果提示,年龄、MR、左心房大小,以及左心室充盈压指标E/E(侧壁、室间隔)是PASP升高的独立性预测因子.结论 二尖瓣脱垂或连枷样二尖瓣引起中-重度器质性二尖瓣反流且左心室收缩功能尚正常的患者,年龄、MR、左心房内径、左心室充盈压及左、右心室舒张功能指标对PASP有预测作用.     

The mitral L wave: a marker of pseudonormal filling and predictor of heart failure in patients with left ventricular hypertrophy.

OBJECTIVES: We sought to examine the relationship of the mitral L wave with echocardiographic indexes of diastolic function and heart failure (HF) events in patients with left ventricular (LV) hypertrophy (LVH). BACKGROUND: The L wave, representing middiastolic transmitral flow, is of unknown clinical and prognostic significance in patients with LVH. Methods Consecutive echocardiograms performed during a 6-month period were screened for patients with LVH, normal LV ejection fraction, in sinus rhythm, and no significant valvular disease. Clinical and echocardiographic characteristics were analyzed, and patients were followed up for incident HF. RESULTS: Of 177 patients, the L wave was present in 35 (20%) (group I) and absent in 142 (group II). Patients in group I had higher early (E) to late (A) transmitral flow velocity (E/A) ratio (1.2 vs 0.8), shorter mitral E wave deceleration time (201 vs 225 milliseconds), lower pulmonary venous systolic/diastolic velocity ratio (1.1 vs 1.6), shorter LV isovolumic relaxation time (83 vs 94 milliseconds), larger left atrial volume (36 vs 23 mL/m 2 ), and higher E to early mitral annular velocity (E/E') ratio (septal E/E', 12.2 vs 9.1; lateral annular E/E', 10.9 vs 7.8) compared with group II (all P < .05). The difference between pulmonary venous atrial reversal and mitral A wave durations was > or = 30 milliseconds in more patients of group I (70% vs 6%, P < .001). During a mean follow-up of 12.0 months, 11 patients were hospitalized for HF. The L wave was associated with a hazard ratio of 4.7 ( P = .011) for incident HF, and remained a significant predictor (hazard ratio 4.2, P = .026) after adjustment for cardiovascular risk factors. CONCLUSIONS: In patients with LVH, the mitral L wave appears to be a marker of pseudonormal LV filling and predictor of future HF events.     

溶栓治疗高血压并发心肌梗死对左室左房重构及功能变化的研究

目的 研究溶栓治疗高血压并发心肌梗死对左室左房重构及功能变化的意义。方法 对69例高血压并发心肌梗死患者（分为溶栓组36例与非溶栓组33例）治疗前后应用超声心动图测量心脏结构和功能各项指标,比较溶栓组与非溶栓组心梗治疗后各项指标：左室舒张末期内径（LVDd)、室间隔与左室后壁舒张末期厚度（IVSTd和LVPWTd)、左室重量指数（LVMI）、左室射血分数（EF）、等容舒张时间（IRT）、左房内径（LAD）、左房面积（LAA）、左房射血分数（LAEF）、二尖瓣瓣尖处测量舒张早期峰值速度（E峰）及舒张晚期峰值速度（A峰）、E／A比值。结果和结论 溶栓组心梗治疗后上述各项指标较非溶栓组明显好转,溶栓治疗高血压并发心肌梗死对防止左室左房重构及其功能变化具有一定的临床意义。     

组织多普勒显像评价二尖瓣置换术后左心室功能

目的 探讨应用组织多普勒显像(TDI)评价二尖瓣置换(MVR)术后左室功能的临床价值.方法 45例接受MVR术后3个月以上患者为病例组,根据心律分为心房颤动组和窦性心律组,并选取30例正常人为对照组.应用常规超声心动图测量左房室腔大小、机械瓣口流速、射血分数等指标;应用TDI测量心尖四腔观二尖瓣环间隔处和侧壁处运动收缩期峰值速度(Sm)、舒张期峰值速度(Em)、等容舒张时间(IVRT);计算E/Em.结果 ①与对照组相比,MVR组二尖瓣环Sm、Em均明显减低,IVRT延长(P＜0.001),但窦性心律组与心房颤动组之间差异无统计学意义(P＞0.05);②MVR组E/Em较对照组明显增高,二者差异有统计学意义(P＜0.001),且E/Em与IVRT呈正相关;以E/Em＞15.0为最佳截断值,评价左室舒张功能变化的敏感性为91.11%,特异性为90.32%,ROC曲线下面积为0.9548±0.0402.结论 TDI能够准确评价MVR后左室功能,E/Em作为一种评价心肌舒张和左室充盈压的量化指标可以评价MVR术后患者左室舒张功能.     

Assessment of left ventricular systolic and diastolic function by Doppler tissue imaging in patients with preinfarction angina.

BACKGROUND: The aim of this study was assessment of left ventricular (LV) systolic and diastolic function by pulsed wave Doppler tissue imaging (DTI) in patients with or without preinfarction angina in acute myocardial infarction. METHODS: We prospectively evaluated 31 consecutive patients (4 women, 27 men; age 58 +/- 10 years) with a first acute myocardial infarction. LV systolic and diastolic function was assessed by classic methods and DTI on the third day during acute myocardial infarction. Patients were divided into 2 groups according to the presence (group 1; n = 10) or absence (group 2; n = 21) of preinfarction angina. Mitral inflow velocities and early diastolic mitral annular velocity (Em), late diastolic mitral annular velocity (Am), peak systolic mitral annular velocity, Em/Am, the ratio of early diastolic mitral inflow velocity (E) to Em, and myocardial performance index were calculated by DTI. RESULTS: Group 1 had significantly higher Em and Em/Am than group 2 (11.3 +/- 3.34 cm/s vs 7.4 +/- 2.07 cm/s, P <.0001; 1.01 +/- 0.38 cm/s vs 0.6 +/- 0.2 cm/s, P =.001, respectively). The E/Em ratio and myocardial performance index were significantly lower in group 1 than in group 2 (5.1 +/- 2.92 vs 8.10 +/- 3.15, P=.018; 0.49 +/- 0.15 vs 0.65 +/- 0.24, P =.042, respectively). Wall-motion score index was lower in those with preinfarction angina than in those without (1.6 +/- 0.36 vs 1.9 +/- 0.39; P =.04, respectively). Peak systolic mitral annular velocity and Am were not statistically different between groups (9.4 +/- 1.84 vs 8.3 +/- 2.03, P =.172; 11.7 +/- 3.07 vs 12.1 +/- 3.34, P =.72, respectively). There were no significant differences between the 2 groups regarding transmitral E velocity, atrial contraction mitral inflow velocity (A), E/A ratio, isovolumetric relaxation time, and deceleration time of the mitral E wave (P =.91, P =.08, P =.58, P =.81, and P =.71, respectively). CONCLUSION: LV diastolic function was better in patients with preinfarction angina than in patients without. This condition could not be detected by conventional mitral inflow Doppler velocities, but could be detected by DTI. This preliminary evidence shows that DTI is better than conventional mitral Doppler indices in the assessment of a favorable LV diastolic function in patients with preinfarction angina.     

定量组织速度成像对心衰患者左室心肌局域收缩及舒张功能的研究

目的　探讨定量组织速度成像 (QTVI)技术在评价心衰患者左室局域收缩及舒张功能方面的临床价值。方法　应用 QTVI技术测定 2 7例健康者 (对照组 )及 30例心衰患者 (异常组 )的左室壁各节段的收缩期峰值速度 (Vs)、收缩期运动位移 (Ds)及快速充盈期、心房收缩期的心肌运动速度 VE、VA 和 VE/ VA 比值 ,测定二尖瓣口血流频谱的快速充盈速度(E)、左房收缩充盈速度 (A)和 E/ A值 ,并将异常组与对照组进行显著性检验。结果　心衰患者的左室壁各节段的 Vs、VE、Ds比正常人显著减低 ,VE/ VA<1,与对照组相比 ,差异有极显著性意义 (P<0 .0 1)。结论　QTVI可快速及无创的定量评价心衰患者的左室壁节段收缩及舒张功能 ,对心衰的早期诊断提供了丰富的影像学依据。     

原发性高血压向心性重塑患者左心构型和功能的变化

目的探讨原发性高血压向心性重塑患者左房、左室几何形状和左室功能变化情况。方法对274例男性原发性高血压向心性重塑患者和146例对照者进行超声心动图检查，测量室间隔厚度(IVST)，左室后壁厚度(PWT)，左室长径(LVL)、舒张末期内径(LVIDd)和内外径(LVID)，左房前后径、内外径、上下径和面积，左室舒张末期容积、收缩末期容积、每搏量及射血分数(EF)，左室舒张早期二尖瓣峰值血流速度(E)和舒张晚期二尖瓣峰值血流速度(A)，计算左室平均横径(LVMD)及E／A值。组间比较行t检验。结果向心性重塑组IVST、PWT、IVST／PWT及左房各径线和面积均大于对照组。向心性重塑组LVIDd和LVID分别短于和长于对照组，LVMD／LVL小于对照组。两组间EF差异无显著性意义。向心性重塑组E／A值小于对照组。结论高血压向心性重塑患者左室质量虽在正常范围，但室壁增厚，心腔变长，左室舒张功能受损，收缩功能保持良好。     

超声心动图根据主动脉瓣和/或二尖瓣反流压差评估左心腔压力价值的探讨

目的采用血浆脑钠素(BNP)和二尖瓣血流频谱舒张早期速度与二尖瓣环组织多普勒舒张早期速度比值(E/Ea)等指标作参照,探讨超声心动图根据主动脉瓣和二尖瓣反流压差评估左心腔压力的临床实用价值。方法研究对象为118例超声心动图存在轻度二尖瓣反流和/或主动脉瓣反流患者(GTOTAL)。其中31例测定了BNP(GBNP),余87例未检测BNP(NGBNP)。常规超声心动图检查记录射血分数(EF),左心房前后径(LAD),常规检测右上肢肱动脉血压(收缩压,Ps;舒张压,Pd)、主动脉瓣反流频谱舒张末期速度(VAR)、二尖瓣反流频谱最大速度(VMR)。根据公式计算:左心室舒张末期压力(LVEDP)=Ps-4VAR2;左心房压力(LAP)=Ps-4VMR2。分析各组BNP、E/Ea、EF以及LAD与LAP和LVEDP的相关性。结果方差齐性检验和一致性检验显示各组间患者分布状态无显著差异(P>0.05)。各组LAP与BNP、E/Ea、LAD和EF均呈中度相关;各组LVEDP与BNP、E/Ea、LAD和EF的相关性差。结论利用二尖瓣反流测算LAP有一定实用价值。但利用主动脉瓣反流测算LVEDP不能客观反映患者的病理生理状态。     

Cardiac resynchronization therapy acutely improves diastolic function.

BACKGROUND: Invasive studies have shown that cardiac resynchronization therapy (CRT) acutely improves left ventricular (LV) systolic performance and lowers filling pressures in a majority of patients with medically-refractory severe heart failure. Measurements included LV volume, ejection fraction, PWD early (E-wave) and atrial (A-wave) velocities, diastolic filling time (DFT), and DTI early diastolic mitral annular velocity (Em) at the lateral and septal annulus; PWD mitral E-wave/Em and E/FP were calculated to estimate LV filling pressures. RESULTS: Immediately after CRT, LV volumes decreased and LVEF increased significantly. PWD mitral E-wave velocity decreased and E-wave duration and DFT increased significantly; mitral E/FP ratio also decreased significantly, consistent with a decrease in LV filling pressure. Patients with a pre-CRT mitral E/A ratio >1 (n = 20), demonstrated improvements in LV diastolic filling and lower filling pressures whereas those with an E/A ratio < or =1 (n = 21) did not show significant changes in diastolic indices. CONCLUSIONS: The acute effects of CRT include echocardiographic evidence of reduced LV volumes and increased LVEF with improved diastolic filling and lower filling pressures; LV relaxation is not significantly altered. The benefits in diastolic function are dependent on the PWD-determined LV filling characteristics prior to CRT.     

Determinants of pulmonary hypertension development in moderate or severe aortic stenosis

Pulmonary hypertension (PHT) is not uncommon in patients with aortic stenosis (AS) and portends a dismal prognosis. We attempted to determine the prevalence of PHT and to identify contributors to its development in patients with moderate or severe AS. A total of 189 patients were enrolled. Patients were divided into two groups according to the presence or absence of PHT, with a pulmonary artery systolic pressure cutoff value of 40 mmHg. Left ventricular (LV) systolic function was assessed by global longitudinal (LV-GLS), circumferential (LV-GCS) and radial (LV-GRS) strains on top of LV ejection fraction (LV-EF). The ratio of mitral E to septal mitral annular e′ velocity (E/e′) was calculated to estimate LV filling pressure. Fifty patients (26.5 %) had concomitant PHT. Patients with PHT had a higher prevalence of diabetes, a lower LV-EF, a higher E/e′, a larger left atrial volume index, a smaller indexed aortic valve (AV) area, and a more reduced LV-GLS (all p < 0.05). However, LV-GRS and LV-GCS were similar in patients with or without PHT. On multivariate logistic regression analysis, LV-GLS and E/e′ were independently associated with PHT, whereas LV-EF and indexed AV area were not. PHT complicating moderate or severe AS is commonly found and is independently associated with systolic and diastolic dysfunction assessed by Doppler and strain imaging, but not with LV-EF.     

Evaluation of left ventricular diastolic function when mitral E and A waves are completely fused: role of assessing mitral annulus velocity.

Mitral inflow parameters have been used most widely in the evaluation of left ventricular (LV) diastolic function. However, when the mitral E and A waves are completely fused, mitral inflow parameters cannot provide information about the LV diastolic function. LV filling pressure, mitral inflow, mitral annulus velocity, and tau (tau) were measured in 59 patients with sinus rhythm when mitral E and A waves were completely fused with right atrial pacing. When mitral E and A waves were completely fused, tau correlated with the peak fused mitral annulus velocity (r = -0.60, P <.001), and peak fused mitral annulus velocity of less than 12.5 cm/s best discriminated prolonged (>/=50 ms) from normal tau, with a sensitivity of 78% and specificity of 69%. The peak fused mitral inflow velocity to peak fused mitral annulus velocity ratio correlated with LV filling pressure (r = 0.62, P <.001). A ratio of at least 8, could predict elevated LV filling pressure (>/=15 mm Hg) with a sensitivity of 65% and specificity of 74%. In conclusion, even when mitral E and A waves are completely fused, mitral annulus velocity can be used in the evaluation of LV diastolic function.     

Aortic root dilatation as a marker of subclinical left ventricular diastolic dysfunction in patients with cardiovascular risk factors

Consensus is lacking about the clinical importance of aortic root dilatation in assessment of the risk of cardiovascular disease. In this study, correlations between aortic root diameter and echocardiographic features of left ventricular (LV) diastolic function were investigated in 333 patients with at least one cardiovascular risk factor (hypertension, diabetes or dyslipidaemia) and preserved LV systolic function. Aortic root diameter was measured by M-mode echocardiography, and LV diastolic function was evaluated by measuring the peak velocity of early (E) and late (A) diastolic transmitral blood flow and peak early diastolic mitral annular velocity (E') by Doppler echocardiography. Linear regression analysis showed that, in men, age was not related to aortic root diameter but hypertension and LV hypertrophy were, whereas the converse was true in women. The parameters E, E/A ratio and E', were related to aortic root diameter in both sexes. Stepwise multiple regression analysis confirmed that E in women and E' in men were independently associated with aortic root diameter. It is concluded that aortic root dilatation might be a useful marker of subclinical LV diastolic dysfunction. Patients with preserved systolic function showing aortic root dilatation should, therefore, be given preventative therapy against LV diastolic heart failure.     

应用肺静脉血流频谱诊断左室舒张功能障碍的临床意义

目的　研究肺静脉血流频谱改变对诊断左室舒张功能障碍的临床价值。方法　应用彩色多普勒超声心动图检查正常人 48例 (对照组 )、冠心病心衰患者 5 2例的肺静脉血流频谱峰值 (Sp、Dp、ap)及其速度时间积分 (Si、Di、ai)和等容舒张时间 ,分别加以对比分析。结果　冠心病组中ap、ai较正常人组显著增大 ,而Si、Dp、Di和Dp/ap、Di/ai值明显减小。ap、ai增大幅度与左室舒张功能障碍明显相关。二尖瓣口血流频谱AP >EP能反应左室舒张功能的一般状态 ,但在心衰晚期常会出现伪正常现象。等容舒张时间的延长也是左室舒张功能障碍表现之一。结论　肺静脉血流频谱可直观反应左室舒张功能障碍 ,特别是在二尖瓣的血流频谱出现伪正常时应有肺静脉血流频谱结合等容舒张时间延长 ,更能充分显示出诊断的可靠价值     

定量组织速度成像和组织追踪法对扩张型心肌病左室功能的分析

目的 探讨定量组织速度成像（QTVI）和组织追踪法（TT）对扩张型心肌病（DCM）患左室收缩和舒张功能的价值。方法 获取标准心尖位左室长轴切面，两腔切面及四项切面，分别应用QTVI和TT技术分析30例正常人和20例DCM患左室长轴方向不同室壁节段即左室前壁、后壁、侧壁、下壁、前间隔和后间隔的心肌多普勒速度曲线和位移曲线；用M-型超声心动图测量收缩期二尖瓣环下移距离（Don）；用二维超声心动图测量左室射血分数（LVEF）：用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。结果 DCM患左室不同室壁节段Vs，Ve，Va和Ds以及LVEF均比正常人显减低。在DCM患中，用定量组织速度成像和组织追踪法测量的二尖瓣环水平Ds与用M-型超声心动图测量的Dm显相关（r=0.64，P=0.005），二尖瓣环水平的平均Vs(r=0.73，P=0.001）、平均Ds(r=0.64,P=0.005）与LVEF分别显相关。正常人与DCM患两组间E/A值无显统计学差异，而DCM患二尖瓣环平均Ve/Va较正常人显减低；正常人中二尖瓣环平均Ve/Va与E/A显相关（r=0.63,P=0.008)，而DCM患二尖瓣环平均Va与E/A无显相关。结论 定量组织速度成像和组织追踪法技术可快速、直观、元创性定量评价扩张型心肌病患左心室收缩舒张功能。     

Pulmonary venous flow velocity: relation to hemodynamics, mitral flow velocity and left atrial volume, and ejection fraction.

Abnormal pulmonary venous flow velocity patterns are present in multiple cardiac disease states, but the determinants of pulmonary venous flow velocity have not been fully elucidated. To determine the relative importance of several proposed factors that could influence pulmonary venous flow, anatomic, hemodynamic, and Doppler mitral and pulmonary venous flow velocity data were compared in 50 consecutive patients undergoing cardiac catheterization for clinical reasons. Pulmonary venous diastolic flow velocity was most strongly related to left ventricular isovolumetric relaxation time (r = -0.59), left ventricular end-diastolic pressure (LVEDP, r = 0.50), left atrial minimum volume (r = 0.50), mitral deceleration time (r = -0.50), and early diastolic mitral flow velocity (r = 0.45). Pulmonary venous systolic flow velocity related best with left atrial minimum volume (r = -0.45) and left atrial ejection fraction (r = 0.44). Pulmonary venous systolic flow velocity integral also showed the strongest relation with left atrial minimum volume (r = -0.48). Relations between pulmonary venous flow velocity and velocity time integrals and other variables were sometimes significantly different, apparently caused in part to differences in heart rate. These results suggest that pulmonary venous diastolic flow velocity is influenced by the same factors that influence early left ventricular diastolic filling; pulmonary venous systolic flow velocity relates best to left atrial volume and atrial ejection fraction and does not relate to left ventricular ejection fraction. Future studies analyzing pulmonary venous flow velocity variables should include data on both peak velocities and velocity time integrals as well as left atrial size and function.