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1.
目的利用定量组织速度成像(QTVI)技术评价左束支传导阻滞左心室整体和局部收缩、舒张活动。方法测量20例完全性左束支传导阻滞(LBBB)患者和20名健康人于标准心尖四腔、两腔及心尖左室长轴切面获得的左心室6个室壁(后室间隔、侧壁、下壁、前壁、后壁、前间隔)基底段、中间段及心尖段同一心动周期各时相时间(ICT、IRT、ET等)以及长轴方向收缩期峰值速度(VS),舒张早期峰值速度(VE)、舒张晚期峰值速度(VA)。结果左束支传导阻滞患者ICT、IRT较正常对照组明显延长(P<0.01),ET缩短(P<0.05);SMPI、DMPI、MPI较对照组明显增高(P<0.01);同一室壁运动虽然存在一定梯度,但VS、VE明显减低。结论LBBB时,左心室内电机械活动不同步,收缩协同失调,引起局部心肌收缩舒张功能减低。  相似文献   

2.
速度向量成像技术对冠心病缺血心肌的初步评价   总被引:11,自引:0,他引:11       下载免费PDF全文
田雪  林艳  张海滨  石晶  李军  张军  朱霆 《心脏杂志》2006,18(6):691-693
目的应用速度向量成像(VVI)技术研究冠心病患者缺血心肌运动速度,初步评价VVI技术的应用价值。方法对照组和冠心病组各20例,VVI技术检测心尖左室长轴切面左室后壁和前间隔基底、中部和心尖节段收缩期峰值速度(Vs)和舒张早期峰值速度(Ve),比较冠心病组和对照组之间各节段Vs、Ve的差异。结果缺血节段Ve较对照组显著降低,个别节段Vs亦显著降低(P<0.05)。结论VVI技术可用于对冠心病患者心肌缺血的评价。  相似文献   

3.
目的探讨心肌局部运动的增龄变化及超声多普勒组织成像改变规律。方法按年龄将112名健康人分为4组:青少年组(≤18岁)24名;青年组(18~39岁)30名;中年组(40~59岁) 29名;老年组(≥60岁)29名。应用定量组织多普勒技术观察各组左心室各节段心肌收缩期峰值速度(Vs)、舒张早期峰值速度(Ve)、心房收缩期峰值速度(Va)和Ve/Va比值,并分析不同年龄组心肌局部运动的特点及其影响因素。结果同一室壁各节段心肌运动速度显著不同,由二尖瓣环水平、基底段、中部到远端运动速度逐渐减低。不同室壁心肌运动速度不同,侧壁、后壁、前壁、下壁较高[环部Ve分别为(9.85±3.02)、(9.80±3.09)、(8.86±3.16)、(8.23±2.48)cm/s],前后间隔最低[环部Ve分别为(6.89±2.60)、(7.94±2.64)cm/s]。各节段心肌运动速度与性别无关,与年龄、ST段时值均数、体质指数、心率相关,其中与年龄的相关性最好。结论左心室各节段心肌收缩及舒张速度呈现规律性的变化,年龄为影响各节段心肌收缩、舒张运动速度的主要因素,各节段心肌舒张功能的增龄性改变更明显。  相似文献   

4.
目的 :应用多普勒组织成像 (DTI)技术测定二尖瓣环运动速度 ,定量分析急性心肌梗死后患者左心室收缩和舒张功能。方法 :研究对象为 6 1例确诊首次急性心肌梗死的患者和 2 0例正常人。常规行超声心动图检查及DTI技术测定二尖瓣环运动速度频谱。记录心尖四腔、心尖二腔和心尖长轴切面多普勒组织成像二尖瓣环运动速度。测定二尖瓣环运动速度参数包括 :二尖瓣环收缩速度 (Sm) ,二尖瓣环舒张早期速度 (Em) ,二尖瓣环舒张晚期速度 (Am) ,二尖瓣环舒张早期速度的比值 (E Em)。结果 :与对照组相比 ,急性心肌梗死后患者DTI可敏感地显示出二尖瓣环收缩和舒张运动速度显著下降(P <0 0 5 ) ;E Em也有显著差别 (P =0 0 13)。DTI二尖瓣环收缩速度与二尖瓣环舒张早期速度之间 ,二尖瓣环收缩速度与左心室射血分数和室壁运动积分之间存在显著的相关性。平均二尖瓣环收缩期速度≥ 8 9cm s预测射血分数 (EF)≥ 5 5 %的敏感性、特异性分别为 88 2 %、70 % ,准确率为 81 5 %。结论 :DTI测量二尖瓣环运动速度 ,作为定量检测急性心肌梗死患者近期心脏功能状态的新方法 ,具有一定的应用价值。  相似文献   

5.
目的 探讨定量组织速度成像(QTVI)技术在评价原发性高血压(EH)患者左室心肌组织运动中的价值.方法 采用QTVI技术获取40例健康查体者(对照组)和60例EH患者(EH组)心尖四腔、心尖两腔、心尖长轴图像,测定左室各壁基底部、中间都、心尖部三个节段收缩期峰值速度(Vs)、舒张早期峰值速度(Ve)、舒张晚期峰值速度(Va)值,并计算Ve/Va.结果 EH组左室各壁Vs、Ve值均显著低于对照组(P<0.05);除左室后壁及下壁心尖部Ve/Va外,其余各壁Ve/Va均明显低于对照组(P<0.05).结论 QTVI能敏感、准确、无创性检测心肌受损情况,此有助于对EH患者病情进行判断和分析.  相似文献   

6.
目的 应用超声心动图评价年龄对正常成年人左室收缩及舒张功能的影响.方法 将804名正常成年受检者分成6组,即1组(20~29岁),2组(30~39岁),3组(40~49岁),4组(50~59岁),5组(60~69岁),6组(70岁以上).于心尖四腔心切面测量二尖瓣口舒张期前向血流频谱,记录舒张早期E波的峰值流速(E) 和舒张晚期A波的峰值流速(A),计算E/ A值;采用Simpson法测量左室射血分数(EF).于心尖四腔及两腔切面分别测量各组受检者左室间隔、侧壁、前壁及下壁二尖瓣瓣环组织多普勒频谱,记录室壁收缩期峰值速度(Sm)、舒张早期峰值速度(Em)、舒张晚期峰值速度(Am)并计算Em/Am,并将每位受检者所得4组数据求平均值.比较各组间数据差异并进行相关性检验.结果 随着年龄的增长,EF值无显著性变化;Sm及E、Em呈逐渐减低趋势(P<0.01);A、Am呈逐渐增高趋势(P<0.01);E/A、Em/Am呈逐渐减低趋势(P<0.01).Sm、E、E/A、Em、Em/Am与年龄呈显著负相关(P<0.001),A、Am与年龄呈显著正相关(P<0.001).结论 正常成年人随着年龄的增长,左室长轴方向的收缩、舒张功能逐渐减低.左室整体舒张功能逐渐减低,而整体收缩功能无变化.  相似文献   

7.
目的 应用应变率成像(SRI)技术评价扩张型心肌病(DCM)患者左心室局部心肌长轴方向收缩和舒张功能.方法 获取18例DCM患者和40例正常对照组心尖左室长轴、心尖两腔、心尖四腔的心肌应变率曲线,测量并比较两组各室壁各节段水平的收缩期、舒张早期、舒张晚期的峰值应变率(SRs、SRe、SRa).测量左室射血分数(LVEF)和二尖瓣口血流的E峰、A峰.结果 DCM组各节段水平的SRs、SRe、SRa明显低于正常对照组(P<0.05或P<0.01).结论 SRI技术能准确可靠地评价DCM患者左室局部心肌收缩和舒张功能.  相似文献   

8.
目的应用组织多普勒技术定量评价缩窄性心包炎(CP)患者手术治疗后心脏各节段功能的改变情况。方法选取已确诊为CP且择期行CP心包剥脱术的患者22例,于手术前后分别行超声检查并存储患者心尖二腔心、四腔心及心尖左室长轴观组织多普勒二维图像,应用定量组织多普勒技术(QTVI)分析并记录术前术后左室各节段收缩期及舒张期峰值速度(S',E')。结果 CP患者术后左室变大,左房及右房有不同程度缩小,左室射血分数(LVEF)增高;左室除后壁外其余节段收缩期及舒张期峰值运动速度S',E'峰均有不同程度的减低;基底水平及中间水平总体S',E'峰亦减低(P0.05)。结论 CP患者术后LVEF增加,心脏各腔室发生趋于正常的重构;术后切除心包的左室游离壁的S'及E'较术前减低,表明在心包剥离术后短期内左室纵向运动速度减低。  相似文献   

9.
定量组织速度成像对高血压患者左室心肌功能的评价   总被引:5,自引:1,他引:5  
目的探讨定量组织速度成像(QTVI)评价高血压患者左室心肌功能的价值。方法于心尖四腔切面,应用QTVI获取20例正常人及66例原发高血压患者不同节段室壁的组织多普勒速度曲线,并测量以下参数:不同节段心肌收缩期峰值速度(Vs)、舒张早期峰值速度(Ve)、舒张晚期峰值速度(Va);应用频谱多普勒(PW)获取二尖瓣口舒张早期血流速度峰值E及舒张晚期血流速度峰值A;于左室长轴,应用M型超声心动图获取左室射血分数(LVEF)。结果1、高血压患者左室心肌Vs与LVEF呈正相关(r=0.9,P<0.001)。2、当基底部心肌Vs>7cm/s、中间部Vs>5cm/s、心尖部Vs>3cm/s时,判定LVEF>50%的敏感性87%、特异性85%。3、高血压无左室肥厚时,节段性心肌Vs与血压正常组无变化,Ve/Va比值下降;当左室发生向心性肥厚时,Vs最高,Ve/Va比值倒置;左室离心性肥厚时,Ve/Va比值倒置,而与通过二尖瓣口血流多普勒频谱测定的E/A出现不一致变化。结论QTVI可以简洁、直观、准确评价心肌功能。  相似文献   

10.
目的探讨定量组织速度成像(QTVI)评价高血压患者左室心肌功能的价值.方法于心尖四腔切面,应用QTVI获取20例正常人及66例原发高血压患者不同节段室壁的组织多普勒速度曲线,并测量以下参数不同节段心肌收缩期峰值速度(Vs)、舒张早期峰值速度(Ve)、舒张晚期峰值速度(Va);应用频谱多普勒(PW)获取二尖瓣口舒张早期血流速度峰值E及舒张晚期血流速度峰值A;于左室长轴,应用M型超声心动图获取左室射血分数(LVEF).结果1、高血压患者左室心肌Vs与LVEF呈正相关(r=0.9,P<0.001).2、当基底部心肌Vs>7 cm/s、中间部Vs>5 cm/s、心尖部Vs>3 cm/s时,判定LVEF>50%的敏感性87%、特异性85%.3、高血压无左室肥厚时,节段性心肌Vs与血压正常组无变化,Ve/Va比值下降;当左室发生向心性肥厚时,Vs最高,Ve/Va比值倒置;左室离心性肥厚时,Ve/Va比值倒置,而与通过二尖瓣口血流多普勒频谱测定的E/A出现不一致变化.结论QTVI可以简洁、直观、准确评价心肌功能.  相似文献   

11.
In the setting of coronary artery disease, two-thirds of LV dysfunction is not the result of irreversible scar, but rather caused by impairment in function and energy use of "still-viable" myocyte. The opportunity for improved function, if coronary blood flow is restored, is there which makes the identification of viable myocardium important. Purpose: The purpose of this study is to identify the value of resting myocardial velocity gradient (MVG) in detecting viable myocardium in patients with healed anterior wall myocardial infarction (MI). Patients and methods: The study included 30 patients with healed anterior MI, who were submitted to conventional echocardiography and tissue Doppler for measurement of MVG. Myocardial perfusion scan using Technetium (Tc)-99m was the gold standard test for the detection of viability. Ten healthy control subjects were also included to obtain reference values for MVG. Results: Resting MVG was able to differentiate infarct regions, and to detect viable myocardium compared to Tc-99m studies (0.68 ± 0.2 vs 0.49 ± 0.22) P < 0.01. Conclusion: MVG provides quantitative assessment of the regional wall thickening that help localizing the infarct zone and detecting viable myocardium at rest.  相似文献   

12.
AIMS: The aim of this study was to determine whether myocardial velocity gradients assessed by M-mode colour Doppler tissue imaging could be of clinical relevance and represent reliable indicators of regional left ventricular function after acute myocardial infarction. METHODS AND RESULTS: Among 64 consecutive patients with a first acute myocardial infarction, in 50 who had a marked asynergy in the parasternal short-axis view at the mid-papillary muscle level, myocardial velocities and velocity gradients were assessed in the anteroseptum and posterior wall by M-mode Doppler tissue imaging. Similar measurements were obtained in 11 matched healthy volunteers who served as a control group. In patients with anterior myocardial infarction, the peak myocardial velocity gradient in the anteroseptum was significantly lower when compared with controls (mean +/- [SD] 0.0 +/- 0.5 vs 1.1 +/- 0.7 s-1 during systole, P < 0.01; and 0.3 +/- 0.6 vs 2.0 +/- 0.5 s-1 during diastole, P < 0.01). Conversely, the peak systolic myocardial velocity gradient in the posterior wall was significantly higher than in controls (2.6 +/- 1.2 vs 1.8 +/- 1.2 s-1, P < 0.05). In patients with inferior myocardial infarction, the peak velocity gradient in the posterior wall was significantly lower when compared with healthy subjects (0.9 +/- 0.6 vs 1.8 +/- 1.2 s-1 during systole and 1.4 +/- 1.4 vs 4.9 +/- 1.2 s-1 during diastole, both P < 0.01). The peak systolic tissue velocity gradient in the anteroseptum was significantly higher than in controls (2.1 +/- 1.0 vs 1.1 +/- 0.7 s-1, P < 0.01). CONCLUSION: The present study indicates that myocardial velocity gradients assessed by M-mode Doppler tissue imaging are of clinical relevance for the characterization of ischaemic myocardial dysfunction after infarction and may provide quantitative assessment of segmental left ventricular function in this clinical setting.  相似文献   

13.
BACKGROUND: The aim of this study is to analyse spatial distribution of myocardial velocities (MV) and myocardial velocity gradient (MVG) with color M-mode Doppler tissue imaging (DTI) and to analyse the influence of age in such parameters. METHODS AND RESULTS: A prospective study including 66 healthy volunteers was carried out with color M-mode DTI. Postprocessing of images was performed using proprietary software allowing the division of the myocardial wall into subendocardium, mesocardium and subepicardium. MV corresponding to the three layers and MVG time curves were obtained and systolic, early diastolic and late diastolic peak values were identified. MV were highest in subendocardium in systole, protodiastole and telediastole compared to external layers. Protodiastolic peak MV decreased in all layers with age, but with a higher impact in the subendocardium (r = 0.72, b = 0.136 (IC 95% 0.107-0.164), p = 0.0005). Older age resulted in larger telediastolic peak MV, without significant differences among layers. Linear correlation between protodiastolic peak mitral flow and peak protodiastolic velocity was higher in endocardium than in other layers (r = 0.79, p = 0.0005). CONCLUSIONS: Color M-mode DTI multilayer analysis showed that endocardium is more susceptible to age-related changes involving diastolic function. This dependency on age should be considered when assessing MV in other clinical settings.  相似文献   

14.
The purpose of this study was to clarify the characteristics of black-blood echo-planar imaging (BB-EPI) in the assessment of infarct-related myocardial edema (IRME), compared with T2-weighted imaging (T2WI). Thirteen acute myocardial infarction (MI) patients after reperfusion and 11 old MI patients underwent BB-EPI and T2WI, excluding those with posterior MI. In acute MI patients, signal intensity ratio (SI ratio) of edema to normal myocardium was measured. Black-blood echo-planar imaging revealed hyperintensity in the same region identified as IRME on T2WI in all acute MI patients, and SI ratio was significantly higher in BB-EPI (2.66 ± 1.58) than in T2WI (1.44 ± 0.22) (P < 0.05). However, BB-EPI showed hyperintensity in posterior wall, where there is no clinical evidence of acute MI, in 2 out of 13 acute MI patients. Both T2WI and BB-EPI detected no IRME in known old infarct area of all old MI patients, but BB-EPI showed hyperintensity in the posterior wall of 4 out of 11 old MI patients. Black-blood echo-planar imaging can depict IRME with sufficient suppression of background and blood flow signals, and with excellent edema-to-normal myocardium contrast resolution. However, BB-EPI sometimes shows an inconsistent signal area with T2WI specifically in posterior wall. The wide practical use of BB-EPI requires the solution to this serious problem.  相似文献   

15.
BACKGROUND: Tissue Doppler imaging (TDI) has been utilized to evaluate left ventricular myocardial dysfunction in patients with hypertrophic cardiomyopathy (HCM); however, no clear explanation for the abnormality of TDI variables has been forthcoming. HYPOTHESIS: Peak negative myocardial velocity gradient (MVG) derived from TDI may correlate with a disorder of fatty acid metabolism in patients with HCM. METHODS: Tissue Doppler imaging and 123I-beta-methyl iodophenyl pentadecanoic acid (123I-BMIPP) myocardial scintigraphy were performed in 15 patients with asymmetric septal hypertrophy (mean age 47 +/- 18 years) and in 12 healthy controls (mean age 43 +/- 10 years). RESULTS: In early 123I-BMIPP images, accumulation defects were observed in the ventricular septum in 12 patients and in the posterior wall in 8 patients with HCM. Peak negative MVG in the ventricular septum (1.1 +/- 0.5 vs. 2.8 +/- 0.5, p < 0.0001) and posterior wall (5.2 +/- 1.4 vs. 6.7 +/- 0.8, p < 0.01 ) was significantly lower in the HCM group than in the controls; also, these parameters were significantly lower in patients with than in those without a defect in the region in question. The peak negative MVG in the ventricular septum and posterior wall correlated inversely with the washout rate in all subjects. CONCLUSIONS: Peak negative MVG according to TDI is related to disorder of fatty acid metabolism in the regional left ventricular myocardium of patients with HCM.  相似文献   

16.
The effects of sublingual nitroglycerin on septal and left ventricular wall motion were determined by echocardiography in the early hours of acute myocardial infarction (MI) in 20 patients admitted via a mobile coronary care unit. Left ventricular and septal echoes were obtained in 11 patients with acute anterior MI and in 9 with acute inferior MI before and after administration of 500 micrograms sublingual nitroglycerin. In the group with acute anterior MI, nitroglycerin did not significantly affect the B-C excursion, posterior wall excursion, and mean posterior wall velocity. Nitroglycerin significantly increased (P less than 0.01), however, the systolic septal excursion, systolic septal velocity, diastolic septal excursion, and diastolic septal velocity. In the group with acute inferior MI, nitroglycerin significantly increased the B-C excursion (P less than 0.01); posterior wall excursion (P less than 0.01); mean posterior wall velocity (P less than 0.01); systolic septal excursion (P less than 0.01); diastolic septal excursion (P less than 0.05), and diastolic septal velocity (P = 0.01) but did not affect the systolic septal velocity. All measurements were obtained by use of a method of labeling and describing specific points of the wall motion that has been described recently.  相似文献   

17.
OBJECTIVE: This study was undertaken to determine right ventricular (RV) function as assessed by colour Doppler tissue imaging (DTI) in patients with RV infarction. METHODS: During the study period, 35 patients were evaluated: 14 patients had an inferior myocardial infarction (MI) with RV infarction and 21 patients had an inferior MI without RV involvement. Twenty age-matched healthy subjects served as controls. The diagnosis of RV infarction was defined by ST segment elevation >0.1 mV in lead V4R. Systolic and early and late diastolic velocities were acquired from the apical four-chamber view at the lateral tricuspid annulus, the septal side of the tricuspid annulus and the RV free mid-wall using colour DTI. RESULTS: Systolic and early diastolic velocities at the lateral tricuspid annulus were significantly reduced in patients with inferior MI with RV infarction compared with those in healthy individuals (7.8 +/- 1 vs. 11 +/- 2 cm/s, p < 0.002) and patients with inferior MI without RV infarction (7.8 +/- 1 vs. 10 +/- 1 cm/s, p < 0.002). The late diastolic lateral annular velocity did not differ between the groups. Systolic and early diastolic RV free wall velocities were also significantly decreased in patients with RV infarction compared with those in healthy individuals (7 +/- 1 vs. 8.7 +/- 1 cm/s, p < 0.01; 6.3 +/- 2 vs. 8.7 +/- 2 cm/s, p < 0.05, respectively) and patients with inferior MI without RV infarction (7 +/- 1 vs. 9 +/- 2 cm/s, p < 0.01; 6.3 +/- 2 vs. 8.3 +/- 2 cm/s, p < 0.05, respectively). CONCLUSION: The evaluation of tricuspid annular and RV free wall velocities using colour DTI provides a rapid and noninvasive tool for assessing RV function in patients with RV infarction.  相似文献   

18.
目的 运用多普勒组织成像技术 (DTI)观察冠心病病变节段收缩波特征。方法 用DTI检测经冠脉造影确诊的 2 8例冠心病患者 (其中 15例心肌梗死 )室壁运动频谱。结果 心肌缺血段 :收缩波速度降低 ;心肌坏死段 :收缩波速度明显降低 ,可有时相缩短或延迟 ;也可有频谱紊乱 ,各波群难以区分 :收缩波也可出现负向。结论 多普勒组织成像技术 (DTl)可作为直观、有效、可靠的反映冠心病病变节段收缩波特征。  相似文献   

19.
目的 建立小鼠心肌缺血再灌注(MI/R)损伤模型,探讨鸢尾素(irisin)能否抑制心肌铁死亡进而发挥心肌保护作用。 方法 将80只5周龄健康雄性C57小鼠随机分为正常对照组(40只)和运动训练组(40只)。运动组完成训练后进一步将两组小鼠分为假手术组和MI/R组(每组20只)。采用小鼠急性MI/R在体模型(缺血30 min,再灌注24 h) 于再灌注后取心肌组织,检测各组血清及组织中irisin水平、铁死亡相关信号表达、心肌梗死面积和整体心脏功能。在细胞学实验中,采用H9c2心肌细胞建立缺氧/复氧(H/R)模型并给予irisin处理后检测铁死亡相关信号表达情况。 结果 铁死亡抑制剂ferrostatin-1可显著减小MI/R心肌梗死面积,降低MI/R心肌中铁死亡标志物Ptgs2 mRNA和丙二醛(MDA)水平,提示心肌铁死亡是MI/R心肌损伤的重要部分。与对照组相比,有氧运动训练可有效提高骨骼肌和心肌中的irisin水平(P<0.05)。运动组MI/R心肌的铁死亡程度被显著抑制,心肌Ptgs2 mRNA、MDA和脂质过氧化程度均显著降低(P<0.05),心功能显著改善(P<0.05)。外源性补充irisin可有效提高MI/R心肌中GPX4水平而抑制心肌铁死亡程度,减小心肌梗死面积(P<0.05)。细胞学实验发现采用siRNA抑制H9c2细胞整合素αV/β5受体可有效阻断irisin对铁死亡的抑制作用。 结论 鸢尾素通过整合素αV/β5受体-GPX4信号途径抑制MI/R心肌铁死亡。有氧运动训练可通过提高内源性irisin水平实现心肌保护作用。  相似文献   

20.
BACKGROUND: The Doppler Tissue Imaging (DTI) is a recent Doppler method that allows to measure the velocities of myocardial walls. Thus, DTI may analyse myocardial contraction and give a quantitative evaluation of systolic and diastolic function. The aim of the study is to appraise the myocardial contraction of the left ventricle in patients with a recent myocardial infarction (MI) comparing data of standard echocardiography with those of DTI. METHODS: Fifteen patients with recent uncomplicated MI (22+/-6 days from the study) and 10 normal subjects have been studied. All population studied underwent bidimensional echocardiography with DTI analysis of different myocardial segments. RESULTS: In the infarcted patients, myocardial velocities were significantly reduced in comparison with the normal subjects in systole and in diastole. In patients with MI the picks of systolic velocities of normokinetic segments were significantly higher than those of akinetic/diskinetic segments (p<0.05). CONCLUSION: In myocardial infarction, the contraction of left ventricle is altered and it can be analysed and quantified through of the new indexes of systolic and diastolic myocardial function furnished by the DTI.  相似文献   

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