超声心动图对高血压病人左室舒张功能再评价

目的 探讨超声心动图对高血压（EH）病人左室舒张功能评价价值。方法 140例EH病人分为左室肥厚组47例,非左室肥厚组93例,予二维超声心动图及Doppler频谱检测,并与25例正常人对照。结果 在正常组和NLVH组,E/A比值、PA值和PAi有显著差异;IVRT、LAD在3组之间有显著差异;EF%值在NLVH组与正常组相似,与LVH组差异有统计学意义。结论 PA、PAi增高、E/A比值减低、IVRT延长和LAD增大是EH左室舒张功能减低的敏感指标。EF值变化提示EH早期左室收缩功能并未受到影响,随着疾病进展而逐步受损。     

糖尿病前期患者左室功能超声心动图评价

目的探讨糖尿病前期（IGR）患者左心室功能的改变。方法应用超声心动图检测40例糖耐量正常者（NGT）及40例IGR患者的左心室收缩功能指标（EF、FS、Sa、SRs）、舒张功能指标（E、A、E／A、Ea、Aa、Ea／Aa、SRe、SRa）及Tei指数。结果①与NGT组相比,IGR组收缩功能指标Sa及SRs降低（P〈0．05）,EF和FS的改变无统计学意义;②IGR组舒张功能指标Ea、SRe、SRe／SRa及Ea／Aa显著降低（P〈0．01或P〈0．05）,而E、A、E／A、Aa和SRa在两组间无显著性差异。③IGR组Tei指数明显增高（P〈0．05）。结论IGR患者已有左室功能受损,超声心动图检测可早期发现糖尿病前期患者的左室功能损害。     

多普勒超声心动图评价心脏舒张功能

多普勒超声心动图已 作为评价左室舒张功能的主要临床工具。然而,心脏舒张是一个十分复杂的过程,多普勒舒张期充盈指标受多个生理变量的影响。本文将复习有关心脏舒张功能的组成因素及多普勒超声心动图评价左室舒张功能的指标。     

超声心动图评价左心室舒张功能的研究新进展

舒张功能障碍常常预示着收缩功能障碍的预后不良,所以正确评价左心室舒张功能对于估测心力衰竭风险具有重要意义。超声心动图评价左心室舒张功能在临床上已应用多年,并且在临床实践中为舒张功能障碍的诊断提供了更全面、更准确的认识。同时,实时三维超声心动图、双脉冲多普勒成像等技术的出现为超声心动图评价左心室舒张功能做了补充,且各具优缺点。     

系统性红斑狼疮患者左心室功能的超声心动图评价

系统性红斑狼疮(systemic lupus erythematosus,SLE)是一种自身免疫性疾病,主要特点是广泛的炎症,循环系统受累是SLE患者死亡的第三位原因[1]。早期发现SLE患者的心脏受累对于治疗和预后有重要价值。超声心动图,特别是组织多普勒成像(tissue Doppler imaging,TDI)技术可以直接测量心肌收缩和松弛速度,是评价心室功能的敏感方法,目前已经广泛应用于评价心室的舒张和收缩功     

两维超声心动图检测左室总体功能的研究

作者报告用两维超声心动图测定正常人、急性和陈旧性心肌梗塞及扩张型心肌病患者左室各切面观面积的缩小率。并应用20平面Simpson(20PS)法测量上述各组患者的左室舒张末期容量,收缩末期容量和喷血分数,显示较简易的双平面椭球体法所测定的各组测值与20PS法不但相关很好(r=0.81～0.98,p<0.01),而且无显著差异(p>0.05),因而可代替20PS法。     

彩色多普勒超声心动图在心脏急诊中的应用

目的:探讨彩色多普勒超声心动图(CDE)在心脏急诊中的应用价值。方法:对我院4年来68例心脏急诊患者进行CDE检查并分析。结果:彩色多普勒超声心动图直接明确诊断或提供重要参考61例,诊断阳性率89.7%。结论:彩色多普勒超声心动图对心脏疾病诊断的准确性高、重复性强、方法简单且无损伤和痛苦,故对正确诊断急诊心脏疾病及指导治疗有重要价值。     

心脏急诊120例床旁超声心动图应用体会

床旁超声心动图在心脏急诊诊断中起着十分重要的作用.作者总结了本院近2 a来行急诊超声心动图检查共120例的资料,报道如下.     

实时三维超声心动图评价左心室功能研究进展

正确评价左心室功能对于临床判断疾病的病情及预后具有重要的意义。实时三维超声心动图(RT-3DE)是评价左心室功能的一种新方法。现就RT-3DE在评价左心室质量、容积和左心室收缩功能、舒张功能以及左心室非同步性分析方面的研究进展予以综述,以期促进RT-3DE在临床评价左心室功能方面的广泛应用。     

应用实时三维超声心动图定量评价心肌梗死后左室节段收缩功能及同步性

目的:探讨实时三维超声心动图(RT-3DE)定量评价陈旧性心肌梗死患者左心室受累节段的收缩功能及收缩同步性的临床应用价值。方法:32例陈旧性心肌梗死患者(心梗组)和20例健康者(正常组)行实时三维超声心动图检查,3D QLAB软件对三维数据库行定量分析,检测左室各节段射血分数(REF)及同步性参数即左室16节段、12节段(6个基底段和6个中间段)、6个基底段达收缩末最小容积的时间标准差以及时间最大差值,经心动周期标化后为Tmsv16-SD%、Tmsv12-SD%、Tmsv6-SD%、Tmsv16-Dif%、Tmsv12-Dif%和Tmsv6-Dif%。结果:与正常组相应节段对照,心梗组受累节段REF显著降低,TmsvSD-16%、Tmsv-16Dif%显著增加。结论:RT-3DE可客观定量的评价心肌梗死节段的收缩功能及收缩同步性。     

多普勒超声心动图对急性心肌梗塞后左室结构和功能变化的评估

为了评价急性心肌梗塞后左室结构和功能的改变,为临床治疗提供实验依据,对３６ 例首发急性心肌梗塞患者于梗塞后４ 周和１２ 周进行了多普勒超声心动图观察。其中溶栓治疗组２１ 例,未溶栓组１５ 例,前壁梗塞组１９ 例,下壁梗塞组１７例。所测参数有：左室舒张末期容积指数（ Ｌ Ｖ Ｅ Ｄ Ｖ Ｉ） ,左室收缩末期容积指数（ Ｌ Ｖ Ｅ Ｓ Ｖ Ｉ） ,射血分数（ Ｅ Ｆ） 及多普勒血流参数。３６ 例急性心肌梗塞患者总体分析结果显示 Ｌ Ｖ Ｅ Ｄ Ｖ Ｉ、 Ｌ Ｖ Ｅ Ｓ Ｖ Ｉ 均明显增高,分别从（５５５ ±１１８）ｍｌ／  升高至（６７８ ±９２）ｍｌ／ （ Ｐ＜ ００１） ,从（２９７ ±６８） ｍｌ／  升高至（３４３ ±６１） ｍｌ／  （ Ｐ＜ ００５） ; Ｅ Ｆ 值无明显变化,由０４６８ ±０１０１ 升高至０４２９ ±０１２３（ Ｐ＜ ００５） 。多普勒血流参数与左室结构和功能改变密切相关。结果表明３６ 例急性心肌梗塞患者总体分析心肌梗塞后 Ｌ Ｖ Ｅ Ｄ Ｖ Ｉ, Ｌ Ｖ Ｅ Ｓ Ｖ Ｉ均明显增高,显示心肌梗塞后均有不同程度的左室形态改变。多普勒血流参数可帮助我们了解心梗后左室结构和功能的变化。由此表明,多普勒超声心动图以其方便实用易     

二尖瓣环自动追踪技术评价心肌梗死患者左心室收缩功能

目的 应用二尖瓣环自动追踪技术评价心肌梗死患者左心室收缩功能。并探讨二尖瓣环自动追踪技术与改良Simpson法在测量左心室收缩功能方面的相关性。方法 受试者共80例,其中健康志愿者47例,心肌梗死患者33例。所有受试者取心尖四腔心切面,应用改良Simpson法测量左室舒张末容积、收缩末容积、每搏输出量、心输出量、左室射血分数、每搏指数、心排指数,转换二尖瓣环自动追踪技术模式分别测量以上指标。采用相关分析比较二尖瓣环自动追踪技术与改良Simpson法对左室功能测量指标的相关性。结果 在正常人中二尖瓣环自动追踪技术与改良Simpson法测量指标相关系数：左室舒张末容积为0.838、收缩末容积为0.917、每搏输出量为0.611、心输出量为0.579、左室射血分数为0.648、每搏指数为0.514、心排指数为0.541。在心肌梗死患者中两种方法测量指标相关系数：左室舒张末容积为0.811、收缩末容积为0.872、每搏输出量为0.797、心输出量为0.774、左室射血分数为0.757、每搏指数为0.708、心排指数为0.754。同一观察者对左室收缩功能各项指标变异范围为1.3%±4.7%。观察者间对左室收缩功能各项指标变异范围为1.8%±5.9%。结论 二尖瓣环自动追踪技术不仅与改良Simpson法对正常人左室收缩功能相关性良好,而且在心肌梗死患者中相关性也很好。二尖瓣环自动追踪技术是评价左室收缩功能的一项简便而准确的方法。     

二尖瓣环运动速度评价心肌梗死患者左心室舒张功能

目的 :用组织多普勒超声技术测定二尖瓣环舒张期运动速度以评价心肌梗死 (MI)患者左心室舒张功能。方法 :对 6 0例正常人和进行门控血池造影 3h内的 30例MI患者的舒张期二尖瓣环运动速度进行测量 ,分别在心尖四腔切面和二腔切面上测量二尖瓣环间隔处、侧壁处、前壁处及后壁处的各位点舒张早期运动速度峰值Em、舒张晚期运动速度峰值Am ,并计算上述四位点Em/Am比值的平均值M ,同时测定二尖瓣口舒张期血流频谱E峰和A峰的E/A比值。结果 :①MI患者的M值较正常对照组明显下降 (P <0 0 5 ) ;②将 30例心肌梗死患者的M值与核素测得的左心室峰充盈率进行相关分析 ,结果明显相关 (r=0 80 ,P <0 0 1 ) ;③在 1 3例心肌梗死患者中 ,二尖瓣血流频谱表现为正常 ,而二尖瓣环运动速度频谱仍能表现出舒张功能的异常。结论 :测量二尖瓣环舒张期运动速度可以评价心肌梗死患者的左心室舒张功能 ,该方法优于二尖瓣血流频谱     

Assessment of the effect of cardiomyocyte transplantation on left ventricular remodeling and function in post-infarction Wister rats by using high-frequency ultrasound

Summary The effects of cardiomyocyte grafting on left ventricular (LV) remodeling and function in rats with chronic myocardial infarction were evaluated using high-frequency ultrasound. Chronic myocardial infarction was induced in 50 Wister rats by ligating the left anterior descending artery. They were randomized into two groups: a trial group that received neonatal rat cardiomyocyte transplantation (n=25) and a control group which were given intramyocardial injection of culture medium (n=25). The left ventricular (LV) geometry and function were evaluated by high-frequency ultrasound before and 4 weeks after the cell transplantation. After the final evaluation, all rats were sacrificed for histological study. The results showed that 4 weeks after the cell transplantation, as compared with the control group, the LV end-systolic dimension, end-diastolic dimension, end-systolic volume and end-diastolic volume were significantly decreased and the LV anterior wall end-diastolic thickness, LV ejection fraction and fractional shortening were significantly increased in the trial group (P<0.01). Histological study showed that transplanted neonatal rat cardiomyocytes were found in all host hearts and identified by Brdu staining. It was suggested that transplantation of neonatal rat cardiomyocytes can reverse cardiac remodeling and improve heart function in chronic myocardial infarction rats. High-frequency ultrasound can be used as a reliable technique for the non-invasive evaluation of the effect of cardiomyocyte transplantation.     

Assessment of the Effect of Cardiomyocyte Transplantation on Left Ventricular Remodeling and Function in Post-Infarction Wister Rats by Using High-frequency Ultrasound

The effects of cardiomyocyte grafting on left ventricular （LV） remodeling and function in rats with chronic myocardial infarction were evaluated using high-frequency ultrasound. Chronic myocardial infarction was induced in 50 Wister rats by ligating the left anterior descending artery. They were randomized into two groups： a trial group that received neonatal rat cardiomyocyte trans- plantation （n=25） and a control group which were given intramyocardial injection of culture medium （n=25）. The left ventricular （LV） geometry and function were evaluated by high-frequency ultrasound before and 4 weeks after the cell transplantation. After the final evaluation, all rats were sacrificed for histological study. The results showed that 4 weeks after the cell transplantation, as compared with the control group, the LV end-systolic dimension, end-diastolic dimension, end-systolic volume and end-diastolic volume were significantly decreased and the LV anterior wall end-diastolic thickness, LV ejection fraction and fractional shortening were significantly increased in the trial group （P〈0.01）. Histological study showed that transplanted neonatal rat cardiomyocytes were found in all host hearts and identified by Brdu staining. It was suggested that transplantation of neonatal rat cardiomyocytes can reverse cardiac remodeling and improve heart function in chronic myocardial infarction rats. High-frequency ultrasound can be used as a reliable technique for the non-invasive evaluation of the effect of cardiomyocyte transplantation.     

Assessment of left ventricular systolic synchronicity by real-time three-dimensional echocardiography in patients with dilated cardiomyopathy

Background Recent advances in real-time three-dimensional echocardiography (RT3DE) offer the potential to assess the left ventricular (LV) dyssynchrony simultaneously by analyzing the 17 segments time-volume curves. The purpose of this study was to test the feasibility and accuracy of RT3DE for quantitative evaluation of left ventricular systolic synchronicity.Methods Twenty-four patients with dilated cardiomyopathy (DCM) and twenty-five healthy volunteers were enrolled in this study. Full volume RT3DE was performed by using Philips IE33 with X3-1 probe. The global and 17-segmental time-volume curves were obtained by the on-line Qlab software (version 4.2). The time to minimal systolic volume in each segment (T(msv)) was taken to derive the following indexes of systolic asynchrony: T(msv) 16-SD, T(msv) 16-Dif, T(msv) 12-SD, T(msv) 12-Dif, T(msv) 6-SD and T(msv) 6-Dif, which meant the standard deviation or the maximal difference of T(msv) among the 16, 12 and 6 segments of the left ventricle respectively. The software also provided with each of the above parameters as a percentage of the cardiac cycle. Results T(msv) 16-SD, T(msv) 12-SD and T(msv) 6-SD were all significantly larger in the DCM group than those of the control group [T(msv) 16-SD: (52.9±40.6) ms vs (8.8±6.2) ms; T(msv) 12-SD: (29.5±30.8) ms vs (6.9±4.0) ms; T(msv) 6-SD: (28.9±34.6) ms vs (7.0±4.7) ms, all P≤0.001]. T(msv) 16-Dif, T(msv) 12-Dif and T(msv) 6-Dif were also significantly larger in the DCM group. There were close negative relations between the LVEF determined by RT3DE and each of the indexes of systolic asynchrony, among which the indexes of T(msv)-16-SD% and T(msv)-16-Dif% correlated most closely (r=－0.703 and r =－0.701, respectively). The DCM patients had significantly larger EDV and ESV, with significantly reduced LVEF compared with the healthy subjects. Conclusion RT3DE provides a simple, useful and unique approach to assess the systolic synchronicity of all the left ventricular segments simultaneously.     

左室肥厚对急性心肌梗死后左室重构的影响

目的：探讨原有的左心室肥厚对急性心肌梗死后左室重构的影响和作用。方法：对２６例前壁心肌梗死患者在入院后ｄ１、ｄ７、１个月和３个月时进行二维超声心动图检查，测量左室舒张琳容积指数（ＬＶＥＤＶＩ）、收缩末期容积指数（ＬＶＥＳＶＩ）、射血分数（ＥＦ）、室间隔厚度（ＩＶＳ）、左室壁厚度（ＰＷ）。结果：无左室肥厚的９例患者在心梗后第一周发生了左室扩张，表现为ＬＶＥＤＶＩ、ＬＶＥＳＶＩ明显增加，无明显的左室扩     

超声心动图对高血压性心脏病患者左心结构及功能的诊断意义

目的：探讨超声心动图（UCG）对高血压性心脏病（HHD）患者左心房结构及功能的诊断价值,为早期诊断和治疗提供依据。方法选取 HHD 患者50例作为观察组,同期体检的健康人群50例作为对照组,采用Philips Sonos 5500型彩超仪,探头频率2.0-4.0 MHz,检测左室射血分数（LVEF）、收缩末期容积（LVESV）、舒张末期容积（LVEDV）、心肌质量（LVMM）、二尖瓣口舒张末期血流速度 E 峰与 A 峰比值、左心房内径（LAD）等指标。结果左心收缩功能组间比较差异无统计学意义（P 〉0.05）;LVEDV、LVMM、LAD 观察组高于对照组,差异有统计学意义（P 〈0.05）;E/ A、LVEF 观察组低于对照组,差异有统计学意义（P 〈0.05）。观察组组内比较,LVEDV、LVD、LVEF、E/ A：Ⅲ期〉Ⅱ期〉Ⅰ期。LVEDV、LVD 与血压值呈正相关,E/ A、LVEF 与血压值呈负相关。结论 UCG 能够直接准确确定左心房增大的面积或左心室肥厚的程度,客观评价心脏功能,为 HHD 的早期诊断、治疗及预后评估提供依据。     

Frequency domain cardiography and radionuclide ventriculography for evaluation of left ventricular function in coronary artery disease

Fifty-six patients with chest pain underwent selective coronaryangiography,radionuclide ventriculography (RNV) and frequency domaincardiography (FCG) to evaluate left ventricular function in coronary artery dis-ease (CAD).The sensitivity,specificity and accuracy of FCG were 87.5%,77.8%and 82.9%,respectively,which were slightly less than those of RNV (92.5%,88.9% and 90.8%,respectively).The changes of FCG scores were negatively corre-lated with changes of LVEF (r=-0.586,P<0.01),and TS (r=-0.679,P<0.01).These results indicate that FCG may be useful for the evaluation of leftventricular function in patients with CAD.