利用超声心动图评定大鼠心脏功能的可行性研究

目的 :通过与血流动力学检测比较 ,确定 M-型超声心动图是否可用来评价正常和心肌梗死大鼠左心室功能和结构变化。方法　利用冠状动脉左前降支结扎术制备大鼠大面积心肌梗死模型后 ,术后 3 d和 3 0 d进行 M-型超声心动图测定、血流动力学检测和取材称左心室重量 ;同时也对心脏功能正常大鼠进行上述研究。结果　用 M-型超声心动图测定心脏功能正常大鼠 ( NOR组 )、心肌梗死急性心力衰竭大鼠 ( AHF组 )和慢性充血性心力衰竭大鼠( CHF组 )的 EF和 FS值与用血流动力学方法测得的 LVdp/ dtmax值呈良好的正相关 ( r=0 .811-0 .972 ,均 P<0 .0 1) ;心肌梗死后 3 d和 1月 EF值与 FS值变化趋势与 L Vdp/ dtmax值变化趋势一样 ,均明显低于 NOR组 (均 P<0 .0 1) ,而且 CHF组各值也明显低于 AHF组 (均 P<0 .0 1)。同时还观察到应用超声心动图测得的三种心功能状态大鼠左心室重量与精密天平检测结果基本一致 (均 P>0 .5 )。结论　无创性经胸壁二维引导 M-型超声心动图可用来动态评价心肌梗死引起的大鼠心脏功能和结构改变     

影响超声心动图心脏功能测定的因素

影响超声心动图心脏功能测定的因素华琦影响超声心动图心脏功能测定的因素颇多，现将有关因素综述如下。一、年龄随年龄增长，室间隔与左室后壁厚度增加，左房与主动脉根部内径加大。Ｇａｒｄｉｎ等［１］观察７０岁以上及３０岁以下的二组健康人，发现高龄组较青年组室间...     

心脏舒张功能不全的超声心动图评价

心脏舒张功能不全指心脏舒张期有生理功能异常,可伴或不伴充血性心力衰竭的症状及射血分数的异常.流行病学表明舒张功能不全十分常见,有报道1/3的心力衰竭患者左室收缩功能正常.目前舒张性心功能不全的诊断来自于临床表现和实验室检查,存在一定的局限性.现介绍心脏舒张功能不全的超声心动图评价,使临床医师更加重视舒张性心功能不全的诊治.     

心脏结构和功能随增龄变化的超声心动图观察

目的 观测心脏结构和功能的增龄性改变及部分影响因素。方法 对306例高校健康教师行超声心动图检查，年龄30－85岁，男165人，女141人。结果 在男女两性，二尖瓣频谱E峰与A峰比值（E／A）、三尖瓣频谱E峰与A峰比值（E／Ar)、主动脉运动幅度（Aao)、室间隔与主动脉根部的夹角（θ）随增龄显著下降（P＜0．001），等容舒张时间（IVRT）随增龄显著延长（P＜0．001），左房前后径（LAD）随增龄显著增大（男P＜0．001，女P＜0．01），左室后壁舒张末期厚度（LVPWTd)及升主动脉径（AOD）在女性随增龄也显著增加（P＜0．05），在男性随龄变化不显著。多因素分析显示，年龄、体重指数（BMI）是E／A、E／Ar、IVRT的独立影响因素；BMI对AOD、LVPWTd及LAD的影响大于年龄，BMI大者E／A减低，IVRT、AOD、LVPWTd及LAD趋于增加。结论 伴随增龄，左右心室舒张功能减低，室间隔形态呈乙状改变，Aao减低，左房、主动脉径增大，左室后壁趋于增厚。女性随增龄室壁厚度的增加较男性显著，肥胖可加速伴随增龄心脏结构及功能的改变。     

超声心动图评价不同海拔地区北方汉族健康人群心脏结构功能特征及差异

目的:利用超声心动图评价不同海拔地区的北方汉族健康人群心脏结构功能特征及差异.方法:来自石家庄市(为低海拔,平均海拔100 m左右)、兰州市(为中高海拔,平均海拔1520 m左右)及海南州(为高海拔,平均海拔3200 m左右)三地的健康汉族人群1208人参与此次调查,获取健康志愿者的左心房前后径(LA-ap)、右心室前...     

超声检测大鼠心脏结构与功能

应用二维与多普勒超声心动图观察大鼠心脏结构和功能 ,并将左室重量的超声测值与实际测值相比较 ,以评价该检测方法的可行性、准确性。将 15只正常 SD大鼠麻醉后 ,应用经胸 7.5 MHz超声检测左室结构指标和左室重量 ,然后处死大鼠测左室重量。结果显示超声测定的大鼠左室重量与尸解结果高度相关 （r=0 .9314,SEE=0 .0 376 ,P<0 .0 0 0 1）。证实经胸超声心动图可以清晰显示大鼠心脏结构与多普勒血流信息 ,是一种准确评价大鼠心脏结构和功能的无创方法     

超声心动图与心脏磁共振成像对比评价中国男举重运动员心脏结构变化

目的:超声心动图与心脏磁共振成像（CMR）对比评价力量训练对运动员心脏结构的影响。方法:该研究为病例对照研究。纳入2019年1月16日至11月1日于北京大学第三医院接受健康体检的男性举重运动员14名,为举重组。纳入14名年龄与之匹配的健康中国男性为对照组。分别采用超声心动图和CMR对受试者心脏结构和功能进行检测。结果:...     

彩色多普勒超声心动图对强直性脊柱炎心脏损害的评价

彩色多普勒超声心动图对强直性脊柱炎心脏损害的评价罗支农，陈薏兰，刘毅，韦怀新对２６例强直性脊柱炎（ＡＳ）患者行彩色多普勒超声心动图检测，以探讨其心脏受累情况，现将结果报道如下。对象与方法ＡＳ２６例，均符合１９７３纽约诊断标准，并排除心肺疾病。其中男住...     

扩张型心肌病与冠心病患者心脏结构及功能超声心动图的差异分析

目的:比较扩张型心肌病(DCM)与冠心病患者心脏结构与心功能超声心动图的差异.方法:将本院2018年6月至2020年8月,收治的31例扩张型心肌病患者纳入DCM组,同期选取收治的38例冠心病心力衰竭患者纳入CHD组,另选35例体检健康的志愿者纳入对照组.三组均行超声心动图检查,DCM组与CHD组同时行冠状动脉造影检查,...     

原发性高血压患者心脏结构和功能改变的流行病学调查

目的:了解北京市合并原发性高血压的住院患者心脏结构和功能改变的特点及相关因素。方法:针对北京地区4 081例原发性高血压住院患者进行流行病学回顾性调查,超声指标包括左心房及左心室内径,室间隔和左心室后壁厚度,E／A比值和左心室射血分数。其他指标包括患者的一般情况、病史和治疗情况。结果:高血压患者左心房扩大和E／A比值异常分别占所有患者的50．6％和70．0％,是高血压心脏损害最常见的两种表现。60～79岁老年人合并各种心脏结构和功能异常的比例均高于中年人。左心房扩大和左心室肥厚呈现出随血压水平升高,异常率增加的趋势。合并心脏结构和功能损害的高血压患者更多的使用联合用药。多因素分析显示,与左心房扩大有关的危险因素有合并心房颤动、肥胖、高龄、高血压病程长以及收缩压增高。与左心室肥厚有关的危险因素同样有高血压病程长、收缩压增高和高龄。与左心室扩大有关的危险因素有女性、合并心房颤动和肥胖。结论:①左心房扩大和E／A比值异常是高血压心脏损害最常见的两种表现;②老年人合并更多的心脏结构和功能损害;③血压水平越高,合并左心房扩大和左心室肥厚者越多;④男性、高血压病程长、收缩压增高和高龄是左心房扩大和左心室肥厚共同的危险因素,合并心房颤动患者合并更多的左心房扩大和左心室扩大。     

Assessment of Right Ventricular Size and Function: Echo Versus Magnetic Resonance Imaging

Objective. The assessment of right ventricular (RV) size and function is important in the management of many patients with heart disease. Although magnetic resonance imaging (MRI) is considered the gold standard for quantitation of ventricular volumes and systolic function, subjective assessment (“eyeball”) by echocardiography is the modality most often used for the RV. The echocardiographic “eyeball” method of assessing RV size and systolic function was compared with quantitative MRI. Design. Patients with right-sided congenital heart disease who underwent an echocardiogram within 6 months of MRI formed the study group. Four echocardiographers blinded to the MRI results reviewed the echocardiograms to subjectively assess RV size and systolic function. The reliability of an echocardiographer in accurately identifying a severely dilated RV and moderately to severely diminished RV systolic function was measured using the Kappa coefficient. Inter-rater agreement was also assessed using Kappa. Results. The study group consisted of 22 patients aged 16.6 ± 7.1 years, with interval between MRI and echocardiogram of 49 ± 54 days. Using echocardiography, reliability for accurately identifying a severely dilated RV was “slight” with a prevalence-adjusted bias-adjusted Kappa (PABAK) of 0.25; and for identifying moderately to severely diminished RV systolic function was fair with a PABAK of 0.43. Inter-rater agreement analysis was poor for both with Kappas of 0.07 (P = .22) and 0.12 (P = .09), respectively. Conclusion. The usefulness of the echocardiographic “eyeball” method to estimate RV size and systolic function in patients with right heart disease has limitations when compared with MRI, specifically in regard to the variability between echocardiographers.     

多普勒组织成像对正常人左心室收缩功能的分析

目的 :应用多普勒组织成像脉冲技术评价正常人左心室整体收缩功能。研究二尖瓣环舒缩速度与左心室整体收缩功能间的相关性 ,以及观察二尖瓣环舒缩速度与左心室射血分数间是否存在直线回归关系。方法 :转换多普勒组织成像速度模式 ,取心尖四腔心、二腔心、心尖左心室长轴切面 ,分别测量二尖瓣环后间隔、侧壁、前壁、下壁、前间隔及后壁的舒张早期峰值速度 (E)、舒张晚期峰值速度 (A)、收缩期峰值速度 (S)。应用改良Simpson法测量左心室射血分数。结果 :左心室射血分数与二尖瓣环前间隔S、E与肺静脉D波比值 (E/D) ,后间隔S ,前壁与后壁的E/D存在直线相关关系。结论 :多普勒组织成像测量二尖瓣环舒缩速度可反映左心室整体收缩功能。并且发现左心室收缩功能不仅与二尖瓣环收缩速度有关 ,而且与舒张速度也相关。二尖瓣环前间隔是反映这一现象的最好位点。     

应用超声心动图评价轻中度高血压左房及左室功能

应用超声心动图自动边缘技术（ＡＢＤ）实时评价２１例正常人及３１例轻中度高血压病人左心收缩及舒张功能。研究结果表明：高血压组病人左室舒张功能受损早于收缩功能受损；左房收缩功能（左房做功）及舒张功能（左房贮存）均增加（Ａｆｓ　４９．１±６．４％ＶＳ　３０．１±５．４％；ｐ＜０．０５；ＳＡＥＩ４１．０±５．０％ＶＳ．３６．３±４．３％，ｐ＜０．０５；ＤＡＥＩ７０．１±６．８％ＶＳ７．１±９．４％，ｐ＜０．００１）；左房左室功能相互联系。因此，在评价高血压心脏功能时，须综合考虑。     

Strain Echocardiographic Assessment of Ventricular Function after Percutaneous Pulmonary Valve Implantation

Introduction. Percutaneous pulmonary valve implantation (PPVI) is an emerging therapy for pulmonary valve dysfunction. Minimal data on the midterm effects of PPVI on ventricular function exist. We describe the effects of PPVI on right and left ventricular (RV, LV) function with speckle tracking echocardiography. Methods. Patients who met the inclusion criteria of the Food and Drug Administration Phase 1 Feasibility Clinical Trial PPVI were identified. Patients were studied with echocardiograms at baseline, post‐PPVI (day of discharge), 3 months, and at 6 months. Patients were studied by cardiac magnetic resonance at baseline and at 6 months. Longitudinal strain was measured at the basal, mid, and apical portions of the RV, interventricular septum (IVS), and LV. Global RV and LV strain and strain rates were recorded. Paired t‐tests were used for analysis. Results. Ten patients were analyzed: nine patients were a variant of tetralogy of Fallot and one patient had complex LV outflow obstruction requiring a Ross and RV‐pulmonary atresia conduit. Mean age was 24.4 ± 7.6 years. Indication for PPVI was pulmonary regurgitation in six patients, stenosis in two patients, and stenosis/regurgitation in two patients. After PPVI, both RV systolic pressure and RV to pulmonary artery pressure gradient significantly decreased. Cardiac magnetic resonance RV end‐diastolic volume significantly decreased. IVS‐mid, IVS‐apical, and LV‐global strain significantly increased and RV‐basal decreased immediately after PPVI. Global RV a' strain rate significantly increased immediately after PPVI. However, RV, IVS, and LV strain/strain rate values between baseline and the 6 month echocardiographic study were either similar or significantly decreased. Conclusion. Despite improvement in RV hemodynamics, there was a decrease or no improvement in RV and LV function as measured by strain echocardiographic values at midterm follow‐up. Larger studies with longer follow‐up are needed to determine if these results remain consistent.     

组织运动二尖瓣环位移自动追踪技术评价冠心病患者左心室功能

目的探讨组织运动二尖瓣环位移自动追踪技术（TMAD）评价冠心病患者左心室收缩及舒张功能。方法经冠状动脉造影证实的冠心病患者（CHD组）27例及年龄匹配的对照组30例,连续测量3个心动周期二尖瓣环4个位点的收缩期峰值位移（Ds）、瓣环连线中点最大位移（Mid）、Mid与左心室舒张期末最大纵径比值（Mid%）、收缩期达峰时间（T）、舒张早期位移（De）及舒张晚期位移（Da）,求均值,计算Da/Dt（Dt＝De＋Da）,并将Ds均值、Mid均值、Mid%均值与双平面Simpson法计算出的左心室射血分数（LVEF）及将Da/Dt与二尖瓣口血流频谱A/E峰值比作相关性分析。结果（1）与对照组相比,CHD组4个位点Ds、Mid、Mid%及其均值均降低（P<0.01）,4个位点达峰时间及其均值均延长（P<0.05或P<0.01）;（2）与对照组相比,CHD组4个位点De及其均值均降低（P<0.01）,侧壁、前壁、下壁Da及4个位点Da均值均增高（P<0.05或P<0.01）,Da/Dt增高（P<0.01）;（3）对照组、CHD组Ds均值、Mid均值及Mid%均值与LVEF呈正相关（对照组：r＝0.697,r＝0.711,r＝0.779,P<0.01;CHD组：r＝0.707,r＝0.703,r＝0.789,P<0.01）;（4）对照组、CHD组Da/Dt与A/E峰值比呈正相关（r＝0.739,r＝0.666,P<0.01）。结论TMAD新技术可以客观、方便地评价冠心病患者左心室功能。     

Left Ventricular Structure and Diastolic Function in Subjects with Two Hypertensive Parents

Purpose : To examine the influence of (i) strong predisposition to essential hypertension and (ii) insulin sensitivity and plasma levels of cardiomyotrophic hormones on echocardiographic parameters of left ventricular structure and function. Methods : 26 normotensive subjects (age 18-35) with bi-parental hypertension and 26 matched controls with normotensive parents. Families with non-insulin-dependent diabetes or morbid obesity were excluded. (i) Echocardiography; (ii) plasma concentrations of renin, angiotensin-II, aldosterone, epinephrine and norepinephrine; (iii) euglycaemic, hyperinsulinemic clamp study. Results (means ±SD): Hypertension-prone subjects vs controls had (i) higher resting systolic (117.0 ±14.0 vs 107.1 ±11.9 mmHg), and 24-h diastolic blood pressure (77.9 ±7.1 vs 72.9 ±7.2 mmHg), (ii) higher relative wall thickness (RWT) (0.39 ±0.09 vs 0.34 ±0.06). They had similar left vetricular mass index, diastolic function parameters, insulin sensitivity and plasma concentrations of cardiomyotrophic hormones. The increased RWT was not attributable to any other factor than the systolic blood pressure. Conclusion : In a carefully selected group of subjects with two hypertensive parents compared to a control group, the only echocardiographic change demonstrated was an increased RWT. This remodelling was attributable to a higher systolic blood pressure in the hypertension-prone subjects, but not to insulin sensitivity or a selection of cardiomyotrophic hormones.     

慢性充血性心力衰竭患者左室运动不同步与右室收缩功能减低的相关性研究

目的探讨慢性充血性心力衰竭(心衰)患者左室运动不同步与右室收缩功能减低之间有无相关性。方法 72例心衰患者行二维应变及常规超声检查。测量前间隔与后壁收缩期轴向应变达峰时间差(SPWMD),以SPWMD≥130ms为左室不同步的标准,测量收缩期三尖瓣环位移(TAPSE)等参数。并以TAPSE≤14mm为截值分为右室收缩功能正常组与减低组。结果 22例(30.56%)患者存在右室收缩功能减低,46例(63.90%)患者存在左室内运动不同步。右室收缩功能正常组与减低组间的SPWMD无明显差异(P=0.658),TAPSE与SPWMD之间无明显相关(r=0.136,P=0.255)。结论心衰患者的右室功能减低与左室内机械运动不同步无明显相关。全面评价心功能需要同时定量分析左、右室功能。     

定量评价左室大小和功能的解剖M型超声新技术

解剖M型是一项超声心动图新技术，其两大特点是①可任意调整取样线的位置，使之垂直通过心室短轴和心室壁，提高了心腔内径和室壁厚度测量的准确性及可重复性；②可同时使用多条取样线，对左室壁多个节段的收缩活动进行定量分析，故有可能提高缺血心肌的检出率，对心脏负荷试验帮助更大。