Usefulness of colour tissue Doppler imaging in assessing aortic elastic properties in Type 1 diabetic patients.

AIMS: Diabetes mellitus (DM) is associated with macrovascular disease and impaired aortic function. We hypothesized that the change in aortic elastic properties could be investigated with colour tissue Doppler imaging (CTDI) in Type 1 diabetic patients and that these findings could be related to the aortic stiffness index. METHODS: We examined by echocardiography 66 patients with Type 1 DM (mean age 35 +/- 10 years, mean duration of disease 20 +/- 9 years) without a history of arterial hypertension or coronary artery disease (negative thallium-201 stress test) and 66 age- and sex-matched normal subjects. Arterial pressure was measured before echocardiography was performed. Internal aortic systolic and diastolic diameters by M-mode echocardiography and aortic systolic upper wall tissue velocity (Sao, cm/s) by CTDI were measured 3 cm above the aortic valve. Aortic distensibility and aortic stiffness index were calculated using accepted formulae. RESULTS: Aortic stiffness, distensibility and Sao velocity differed significantly between the studied groups. In the diabetic group, duration of diabetes correlated with aortic stiffness (r = 0.53, P < 0.001), distensibility (r = -0.61, P < 0.001) and Sao velocity (r = -0.48, P < 0.001). There was a negative correlation between aortic stiffness and Sao velocity (r = -0.49, P < 0.001). Multiple stepwise linear regression analysis in the diabetic group revealed that aortic S velocity (beta = 0.30, P = 0.005) and duration of diabetes (beta = -0.49, P = 0.001) were the main predictors of aortic distensibility (overall R(2) = 0.48). CONCLUSIONS: Aortic elastic properties can be directly assessed by measuring the movements in the upper aortic wall. Reduced aortic S velocity is associated with increased aortic stiffness in Type 1 diabetic patients.     

Tissue Doppler imaging for the diagnosis of coronary artery disease

PURPOSE OF REVIEW: Tissue Doppler imaging (TDI) is a diagnostic method that provides quantitative data about myocardial function. The present review discusses the most recent developments in the application of TDI in coronary artery disease. RECENT FINDINGS: The most widely used TDI modality is velocity imaging, and systolic function is measured as peak velocity during LV ejection. Several recent studies show that TDI measurements during the LV isovolumic phases provide unique information regarding myocardial dysfunction. Since velocity imaging is confounded by influence from velocities in other segments, the TDI-based modalities strain- and strain rate imaging (SRI) have been introduced to measure regional shortening fraction and shortening rate, respectively.Velocity imaging during stress echocardiography has been validated clinically and appears equivalent, but not superior to conventional visual assessment of grey scale images. Potentially, more comprehensive evaluation that includes the use of SRI may improve the diagnostic power of TDI further. Preliminary reports suggest that TDI may have an important role in the assessment of viability in acute coronary occlusion, but this needs to be demonstrated in appropriately designed clinical trials. SUMMARY: At the present time tissue Doppler velocity imaging can be recommended for clinical use, especially the pulsed mode. Strain rate imaging may be useful as additional imaging, but needs further refinement before it is ready for routine clinical use.     

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。     

Diagnostic value of dobutamine stress Doppler tissue imaging in diabetic patients with suspected coronary artery disease

BackgroundCoronary artery disease (CAD) is often silent in diabetic patients, and it is typically in advanced stages of development by the time it manifests. Various forms of stress testing have been investigated to detect obstructive CAD in diabetes mellitus.ObjectivesTo assess the diagnostic value of dobutamine stress pulsed-wave Doppler tissue imaging (DTI) compared with standard wall motion analysis in detection of myocardial ischemia in diabetic patients with suspected CAD.MethodsThe study comprised 46 diabetic patients with suspected CAD who underwent dobutamine stress echocardiography (DSE) with DTI within 4 weeks before coronary angiography (CA). Dobutamine infusion started at 5 μ/kg/min and increased up to 40 μ/kg/min with additional atropine during submaximal heart rate responses. In addition to wall-motion score index (WMSI) analysis, pulsed-wave DTI examination of basal and mid segments of posteroseptal, lateral, anterior, inferior and anteroseptal walls was performed. Myocardial velocities were measured at rest in the apical 4, 3 and 2-chamber views. The measurements were repeated at low dose (10–15 μ/kg/min) and at peak stress (40 μ/kg/min). DTI measurements included peak systolic velocity (S), peak early diastolic velocity (E) and peak late diastolic velocity (A) and the results were compared to WMSI analysis. Patients were classified into two groups according to CA results; group (I) diabetics with positive CA (n = 27) and group (II) diabetics with negative CA (n = 19).ResultsThere was no significant difference between the two groups in duration of diabetes, global WMSI at rest or the Δ changes (stress-rest/rest) of WMSI (p > .05). Global S and global E were significantly lower in group I compared to group II at peak stress (11.3 ± 3.7 cm/s vs. 14.5 ± 2.2 cm/s, p < 0.01) and (11.3 ± 1.6 cm/s vs. 13.1 ± 2.1 cm/s, p < 0.01) respectively. The cutoff points for global S and global E to detect obstructive CAD in diabetics were 11.3 cm/s and 11.2 cm/s respectively with 75.7%, 73.4% sensitivity and 94.7%, 89.47% specificity respectively. An increment (Δ changes) less than 0.56 in S or 0.26 in E from rest to peak stress identified CAD with 78.8%, 89.3% sensitivity and 94.7%, 90.7% specificity respectively. The accuracy of DTI parameters during peak stress was higher than WMSI analysis (sensitivity 74.1% vs. 59.3% and specificity 90% vs. 79%, p < 0.01 for each). In multivariate regression analysis, only ΔS and ΔE were independent predictors of obstructive CAD in diabetics (odd ratio: 36.16, 95% CI, 1.34–532.01 and 63.77, 95% CI, 3.19–721.47) respectively.ConclusionQuantitative analysis, using DTI during DSE, adds new dimension in diagnosis of myocardial ischemia. It is more sensitive, specific, accurate and reproducible compared with standard wall motion analysis for recognition of significant CAD in diabetic patients.     

Intravascular ultrasound imaging for assessing regression and progression in coronary artery disease

New imaging techniques have been used as surrogate markers of atherosclerotic burden to determine the effects of pharmacologic intervention. The aim of this study was to better determine potential utility and limitations of intravascular ultrasound (IVUS) imaging for assessing regression and progression in coronary artery disease. Medline was searched for randomized trials using IVUS for assessing regression and progression in coronary artery disease (through September 2009). A comparison of IVUS studies with large trials evaluating the same issue with clinical end points was performed. A total of 26 relevant reports (8,631 patients randomized [median 207.5], 5,794 patients analyzed [median 152], duration 2 weeks to 3.4 years [median 12 months]) were identified. Three frequently used IVUS variables were the focus of the analysis: (1) nominal change in plaque volume, (2) percentage change in plaque volume, and (3) nominal change in percentage plaque volume. These variables were presented in 21, 12, and 11 studies, respectively. The variables were the primary end points in 4, 5, and 4 studies, respectively. Large variance with a relatively small difference was noticed in all 3 variables. Fewer than half of the variables showed statistically significant differences in comparing groups. Comparison of IVUS studies with large trials evaluating the same issue with clinical end points showed consistent and inconsistent results. In conclusion, the current method of calculating plaque volume using IVUS seems logical, and some clinical outcomes trials have yielded some evidence. Future studies are needed to determine which IVUS variable is the best surrogate to determine the effects of pharmacologic intervention in patients with coronary artery disease.     

超声检测心外膜脂肪组织与颈总动脉内中膜厚度在预测冠心病中的诊断价值

目的 探讨心外膜脂肪组织(EAT)与颈总动脉内中膜厚度(CIMT)、冠心病的相关性,进一步分析EAT预测冠心病的意义.方法 入选确诊冠心病需行冠脉造影住院患者160例(其中非冠心病86例,冠心病74例),入院后10d内彩超检测EAT厚度、CIMT厚度,分析EAT厚度与CIMT厚度、冠心病的相关性.结果 相关性分析显示,EAT厚度与CIMT有较好的相关性(r=0.79,P＜0.001);冠心病组EAT、CIMT较非冠心病组明显高[(8.65±1.45)vs (6.30±1.53)mm;(1.17±0.21)vs(0.83±0.19)mm;均P＜0.01)];CIMT≥0.92 mm预测冠心病的敏感度、特异度、Youden指数分别为0.81、0.78、0.59,EAT≥7.24 mm预测冠心病的敏感度、特异度分别为0.84、0.80、0.64.结论 超声检测EAT和CIMT可作为冠心病的预测指标.     

Value of tissue Doppler imaging to predict left ventricular filling pressure in patients with coronary artery disease

Assessment of left ventricular (LV) diastolic filling pressure provides important information on the hemodynamic status in the general population. The aim of our study was to investigate the reliability of tissue Doppler imaging (TDI) in estimating left ventricular filling pressure in patients with coronary artery disease (CAD). We prospectively studied 32 consecutive CAD-patients, mean age 64 +/- 12 years, in sinus rhythm. All patients underwent cardiac catheterization and echocardiography within the same hour. Catheterization investigated pre-A-wave pressure (preA) and LV ejection fraction (LVEF). Echocardiographic LVEF was calculated using wall motion indexes (WMI) with segmental division of LV wall. The following Doppler parameters were assessed: (1) PW Doppler signals from the mitral inflow (E), (2) PW TDI of the mitral annulus (E'), thus allowing to obtain the mitral inflow to annulus ratio (E/E'). The best correlation between invasive and echocardiographic LVEF was observed using WMI (r = 0.91). The correlations between preA and E, E', and E/E' were significant (r = 0.36, r = 0.38, and r = 0.60, respectively). In patients with LVEF >50%, no correlation between E/E' and preA was found (r = 0.18, P = 0.44), whereas with LVEF <50%, this correlation was strong (r = 0.76, P < 0.001). In patients with myocardial infarction, the correlation between E/E' and preA was significant whatever the localization of myocardial infarction (r > 0.71, P < 0.05). ROC curve analysis identified an E/E'>9 to be the best cut-off value related to preA > 15 mmHg. We conclude that the mitral inflow-to-annulus ratio is a reliable method in CAD patients and allows determination of LV filling pressure when LVEF <50%.     

Aortic stiffness is increased in patients with premature coronary artery disease: A tissue Doppler imaging study

BackgroundAtherosclerosis and arterial stiffening may coexist and the correlation of these parameters in patients with premature coronary artery disease (CAD) has not been well elucidated. Tissue Doppler imaging of the ascending aorta may be used in the assessment of elastic properties of the great arteries.ObjectiveTo investigate the correlation between aortic stiffness and premature CAD using parameters derived from two-dimensional and tissue Doppler imaging (TDI) echocardiography of the ascending aorta.MethodsFifty consecutive subjects younger than 40 years old who were hospitalized with diagnosis of acute coronary syndrome and had undergone coronary angiography were recruited. The control group included 70 age–sex matched individuals without a diagnosis of CAD. Aortic stiffness index (SI), aortic distensibility (D), and pressure-strain elastic modulus (E_p) were calculated from the aortic diameters measured by two-dimensional M-mode echocardiography and blood pressure obtained by sphygmomanometry. Aortic systolic velocity (S_Ao), and early (E_Ao) and late (A_Ao) diastolic velocities were determined by pulse-wave TDI from the anterior wall of ascending aorta 3 cm above the aortic cusps in parasternal long-axis view.ResultsStiffness index was higher [median 5.40, interquartile range (IQR) 5.98 vs. median 4.14 IQR 2.43; p = 0.03] and distensibility was lower (median 2.86 × 10⁻⁶ cm²/dyn, IQR 2.51 × 10⁻⁶ cm²/dyn vs. median 3.46 × 10⁻⁶ cm²/dyn, IQR 2.38 × 10⁻⁶ cm²/dyn; p = 0.04) in patients with CAD compared to the control group. E_Ao was significantly lower in the CAD group (7.2 ± 1.8 cm/s vs. 9.2 ± 2.4 cm/s, p < 0.01). The difference in E_Ao remained significant when CAD patients with a left ventricular ejection fraction >55% was compared to the control group. S_Ao and A_Ao velocities of ascending aorta were similar in control and CAD groups. There was a significant correlation between E_Ao velocity and aortic stiffness index (r = −0.28, p = 0.01), distensibility (r = 0.19, p = 0.04) and elastic modulus (r = −0.24, p = 0.01). In multivariate regression analysis, decreased levels of high-density lipoprotein cholesterol [odds ratio (OR): 1.12 95% CI 1.06–1.19; p = 0.01] and E_Ao (OR: 1.41 95% CI 1.12–1.79; p = 0.01) measurements remained as the variables independently correlated with premature CAD in the study group.ConclusionArterial stiffness is increased in patients with premature CAD. E_Ao of the anterior wall of ascending aorta measured with pulse-wave TDI echocardiography is correlated with arterial stiffening and is decreased in patients with premature CAD.     

Role of intravascular ultrasound imaging for assessing pathophysiology of coronary artery disease

It has been nine years since intravascular ultrasound imaging(IVUS) was for the first time performed in Japan at our hospital. During this period, the progress of catheter technology brought about many improvements in catheter design and image quality. Also clinical utility of IVUS has been widely recognized with accumulation of clinical experiences. The most important feature of this method is the capability of both quantitative and qualitative analyses of the atheroma. IVUS has mainly been used to help guide procedures during catheter interventions and has provided information about the mechanisms of dilatation and restenosis. Recently, the ability of IVUS in diagnosing morphologic changes such as compensatory enlargement, vessel shrinkage and plaque rupture has much attention. IVUS should enhance our understanding of the pathophysiology of coronary artery disease.     

应用多普勒组织成像技术观察曲美他嗪对冠心病左心室局部收缩和舒张功能的影响

目的观察曲美他嗪(trimetadine,TMZ)对冠心病左室局部收缩和舒张功能的影响,并评价多普勒组织成像技术(DTI)在研究药物改善局部心肌功能中的价值.方法42例冠心病患者,随机分为两组.对照组20例,服用硝酸异山梨酯+钙通道阻滞剂+阿司匹林;TMZ组22例,在上述药物基础上加用TMZ.应用DTI技术测量两组服药前后左室壁12个节段收缩期峰值速度(VS),和舒张早期峰值速度(VE).并计算12节段心肌平均收缩峰值速度(VS)和舒张早期峰值速度(VE).结果(1)TMZ组用药后室壁12节段中,有7个节段的VS和VE显著升高(均P＜0.05),对照组治疗前后比较VS和VE差异无显著性.(2)VS和VE在TMZ组治疗后,分别由(3.94±1.26)cm/s升高至(4.78±1.30)cm/s(P＜0.05);(4.15±1.33)cm/s升高至(5.04±1.37)cm/s,均P＜0.05.(3)TMZ组治疗后运动异常节段的恢复数显著高于对照组(P＜0.0).结论(1)TMZ可改善冠心病患者的左室局部收缩和舒张功能.(2)DTI能够定量分析冠心病缺血心肌对药物治疗前后室壁运动的变化,对指导临床用药有一定应用价值.     

冠状动脉钙化积分预测老年冠心病的相关研究

目的进一步探讨预测老年冠心病的新指标,预防心血管事件的发生。方法对≥60岁老年人66例(冠心病48例,非冠心病18例)进行多层螺旋CT(MSCT)冠状动脉扫描和计算机自动测定冠状动脉钙化积分(CACS),对CACS结果进行分析。结果老年冠心病组的CACS明显高于非冠心病组(P<0·01)。3支血管钙化者CACS明显高于1支及2支血管钙化者,且钙化发生在任意血管段都有明确意义(P<0·01,P<0·05)。结论CACS优于传统危险因子,可作为预测冠心病的新指标之一。     

The signal-averaged electrocardiogram in predicting coronary artery disease

The ability to noninvasively detect coronary artery disease (CAD) in patients undergoing diagnostic cardiac catheterization was studied using a signal-averaged electrocardiogram. An initial study of 13 patients revealed that a QRS duration greater than or equal to 100 msec, a root mean square voltage in the terminal 40 msec of the QRS less than 50 microV, and a low amplitude signal (LAS) duration greater than 28 msec were suggestive of CAD. These parameters were then used prospectively to examine 40 consecutive patients with chest pain of undetermined etiology referred for cardiac catheterization. Patients with CAD had significantly longer filtered QRS and LAS durations and lower root mean square voltages compared with patients without CAD. The sensitivity, specificity, and positive predictive value of a single parameter ranged from 62% to 76%, 74% to 89%, and 75% to 87%, respectively. Thus the signal-averaged electrocardiogram may be a useful tool in evaluating patients for the presence of CAD.     

组织多普勒观察冠状动脉旁路移植术后心肌功能的变化

目的 评价冠状动脉旁路移植(coronary artery bypass graft,CABG)后组织多普勒(tissue Dopplerimaging,TDI)所反映的心肌收缩、舒张功能的长期变化趋势.方法 55例稳定型心绞痛患者于CABG术前、术后1周、1月、1年分别记录二尖瓣环运动的组织多普勒指标.其中43例为体外循环CABG,12例为非体外循环CABG.另外选择20例正常人群设为对照组.结果 二尖瓣跨瓣血流频谱E/A在手术前、后无明显变化,组织多普勒显示左心室舒张功能在术后1年内显著改善[术前、术后1周、1月、1年时二尖瓣环舒张早期峰值分别为(6.7±2.6)cm/s, (7.1±2.6)cm/s, (7.7±2.1)cm/s, (8.2±2.3)cm/s,P<0.05],左心室收缩功能在手术前后无显著改变.体外循环与非体外循环CABG患者舒张功能改善情况并无区别.结论 稳定型心绞痛患者的左心室舒张功能在CABG后迅速改善,并在手术后1年内逐步增强.     

组织多普勒超声评价冠状动脉狭窄患者左心室舒张功能

目的探讨组织多普勒超声评价冠状动脉不同狭窄程度对左心室舒张功能的影响。方法在我院行冠状动脉造影检查的患者219例,根据造影结果分为3组,冠状动脉病变严重组(至少1支血管狭窄≥70%,A组),冠状动脉病变轻微组(血管狭窄70%,B组)和冠状动脉造影检查正常组(C组)。应用超声测量冠心病患者二尖瓣舒张早期血流峰值(E)与组织多普勒成像二尖瓣环舒张早期峰值(Em)的比值(E/Em)。结果 A组的E/Em较B、C组高,差异有统计学意义(P0.05,P0.01),B组与C组比较,E/Em差异无统计学意义(P0.05)。结论E/Em可检测出冠状动脉高度狭窄引起的左心室功能障碍。     

Clinical usefulness of tissue Doppler imaging in predicting preclinical Fabry cardiomyopathy

Fabry cardiomyopathy (FC) is characterized by left ventricular hypertrophy (LVH). The aim of this study is to determine whether early changes revealed by tissue Doppler imaging (TDI) are useful for detecting preclinical cardiac abnormalities in patients with this X-linked genetic disorder. If so, this tool could help in deciding whether to begin enzymatic therapy earlier than otherwise. METHODS AND RESULTS: 59 consecutive patients with confirmed Fabry disease (FD) underwent conventional and TD echocardiography. FD patients with and without LVH had significantly lower early diastolic tissue Doppler velocities (Ea) compared with the control group (P<0.001); The isovolumic relaxation time (IVRT) was significantly longer in the FD group with LVH (P<0.001). Isovolumic contraction time (IVCT) was significantly shorter in the FD group without LVH compared with the control group (P<0.001). Additionally, peak systolic wall motion velocity (Sa) was significantly lower in patients with LVH, compared with those without LVH (P<0.001). The systolic myocardial velocity correlates inversely with septum and posterior wall thickness (r: -0.74 and r: -0.90; P<0.001 respectively). In respect of predicting preclinical cardiac impairment, the area under the ROC curve of 0.83 suggests an optimal IVRT cut-off point of 60 ms for separating early cardiac impairment from the established condition. This gives a 96.6% specificity rate for the early detection of cardiac involvement. The best parameter for detecting preclinical FC is the IVCT, with a cut-off point of 105 ms, which shows high sensitivity and specificity (100% and 91%, respectively; AUC: 0.97). CONCLUSIONS: Myocardial contraction and relaxation evaluation confirms that TDI is a reliable method for early identification of preclinical FC, even before FC patients develop LVH.     

定量组织速度成像技术评价冠心病患者冠状动脉病变的价值

目的探讨定量组织速度成像(QTVI)技术评价冠心病患者冠状动脉病变的价值。方法选择经冠脉造影诊断为冠心病的患者41例,根据冠脉造影结果将所有患者左心室各节段分为无病变、轻度病变、中度病变和严重病变节段4组,应用组织多普勒定量组织速度成像技术,测定所有患者在静息和潘生丁负荷状态下左心室各节段室壁运动变化,并与冠脉造影所得的结果相比较。结果冠脉病变节段的平均收缩期运动速度(Vs)较正常节段减低,舒张早期充盈速率(Ve)和舒张晚期充盈速率(Vs)比值<1,节段心肌等容舒张时间(RIVRT)延长。结合潘生丁负荷试验可使这些变化更明显,以冠脉造影结果为标准,其判断血管病变敏感性为93.7%,特异性为86.4%。结论定量组织速度成像技术检测左心室各节段心肌功能变化,可用来评价冠心病患者冠状动脉病变,结合潘生丁负荷试验,可提高判断的敏感性和特异性。     

Tissue Doppler imaging in coronary artery diseases and heart failure

Recent studies have explored the prognostic role of TDI-derived parameters in major cardiac diseases, such as coronary artery disease (CAD) and heart failure (HF). In these conditions, myocardial mitral annular systolic (S') and early diastolic (E') velocities have been shown to predict mortality or cardiovascular events. In heart failure non invasive assessment of LV diastolic pressure by transmitral to mitral annular early diastolic velocity ratio (E/E') is a strong prognosticator, especially when E/E' is > or =15. Moreover, other parameters derived by TDI, as cardiac time intervals and Myocardial Performance Index, might play a role in the prognostic stratification in CAD and HF. Recently, a threedimensional (3-D) TDI imaging modality, triplane TDI, has become available, and this allows calculation of 3-Dvolumes and LV ejection fraction. We present a brief update of TDI.     

Improved detection of spontaneous echo contrast in the aorta with tissue Doppler imaging

AIMS: Spontaneous echo contrast (SEC) within the cardiac chambers has been associated with increased risk of thromboembolism. We investigated the presence and severity of SEC in the aorta with tissue Doppler imaging (TDI) and compared these to the aortic flow velocity and to the clinical profile of the patients. METHODS AND RESULTS: Seventy patients (35 males, 35 females, mean age 64, 22-86 years) underwent TEE for standard indications. Spontaneous echo contrast was studied with conventional and TDI imaging. Aortic flow velocity was measured in the center and lateral part of the descending aorta. SEC of any grade was detected in 24 patients with conventional imaging and in 53 using TDI (P < 0.0001). The presence of swirling was associated with aortic atherosclerosis, older age, history of hypertension and coronary artery disease, atrial fibrillation, and previous embolic events. There was correlation between intraaortic swirling, larger descending aortic diameter (23.6 vs 17 mm, P < 0.00001) and lower peak aortic flow velocity (55 vs 68 cm/s, P = 0.038). CONCLUSION: Spontaneous echo contrast in the aorta is common in high-risk patients and is associated with increased clinical profile, larger aortic diameter, and lower peak aortic flow velocity. Tissue Doppler imaging is more sensitive in the detection of SEC than conventional imaging.     

组织多普勒成像技术评价左心室舒张功能的临床价值

为探讨组织多普勒成像技术 ( TDI)评价左室舒张功能的价值 ,将 5 7例左室舒张功能减退患者分为三组。应用 TDI测定其二尖瓣环运动速度 ;脉冲多普勒技术测定其二尖瓣口和肺静脉血流频谱 ,并与 32例健康志愿者 (对照组 )比较。结果舒张早期心肌运动峰值速度在对照组、左室心肌松弛性减低组 ( 16例 )、左室充盈假性正常化组 ( 2 7例 )和限制性充盈组 ( 14例 )分别为 ( 12 .0± 3.6 ) cm/ s、( 7.9± 2 .3) cm/ s、( 7.6± 2 .2 ) cm/ s和 ( 7.5±3.1) cm / s;对照组与其他三组比较 ,P值均 <0 .0 0 1。认为 TDI测定舒张早期心肌运动峰值速度对评价左室舒张功能减退程度具有重要价值