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1.
应用脉冲多普勒超声心动图对比观测了14例正常人及20例冠心病患者在瓦氏动作中二尖瓣血液多普勒频谱的变化。结果表明,瓦氏动作可导致冠心病患者E/A比值明显减小。本研究提示,瓦氏动作为一快速降低压房压的有效方法;它可显著提高左室舒张能紊乱患多普勒超声心动图的检出率。 相似文献
2.
M型和脉冲多普勒超声心动图检测左室舒张功能53例陕西省城固县城关医院周振明,李园本文同时应用M型和脉冲多普勒超声心动图二种检测方法,对53例患者进行左室舒张功能评价,分别以二尖瓣前叶EF斜率和脉冲多普勒左室流入道频谱E/A比值作为评价指标。结果:EF... 相似文献
3.
徐渝 《中国超声医学杂志》1994,(2)
多普勒超声评价冠心病左室舒张功能重庆市第八人民医院B超室徐渝本文总结了我院1991年以来,应用彩色、脉冲多普勒超声心动图(PDE)对70例冠心病(CAD)患者左室功能的测定,并与30例正常人进行对照。结果显示,冠心病患者心脏二尖瓣口血流,舒张早期充盈... 相似文献
4.
应用超声心动图及多普勒超声检测103例非胰岛素依赖型糖尿病(NIDDM)患者和51例健康人左心室功能和结构参数。结果:各组NIDDM恩者左室舒张功能均有异常,收缩功能障碍仅见于伴大血管病变者。与正常人比较,糖尿病患者PVA和PVA/PVE升高,PVE和MEF降低;LVST、LVPWT、LVM和LWI增加;伴大血管病变者SV、CO及EF均减少。结论:NIDDM患者常见左室舒张功能障碍,甚至可见于无血管并发症者,左室重量亦明显增加。超声心动图及多普勒超声可用于探测糖尿病患者心功能的早期异常并有助于糟尿病性心肌病的诊断。 相似文献
5.
脉冲多普勒超声心动图检测正常人(30例)、高血压病患者(56例)和陈旧性心肌梗塞患者(30例)的二尖瓣口舒张期血流频谱,比较1/2E峰减速时间与E峰加速时间比值(Td/Ta)、E/A、Ei/Ai评价左室舒张功能(LVDF)的价值。结果:1.与正常组比... 相似文献
6.
冠心病患者冠脉血流储备变化的临床意义 总被引:3,自引:0,他引:3
用食管多普勒超声心动图研究20例正常人,37例冠心病患者的冠脉血流储备(CFR)。在左冠状动脉主于分枝处用脉冲多普勒测定舒张期最大血流速度(PDV)和收缩期最大血流速度(PSV)。以潘生丁静注后和静息时的PDV比率(D/RPDV)和PSV比率(D/RPSV)作为CFR指标(Iliceto氏法)。结果发现冠心病患者D/RPDV,D/RPSV分别为1.56±0.41,1.43±0.30较正常人2.59±0.70,2.38±0.58明显减少(P<0.01),冠心病患者32/37(86.5%)例D/RPDV,D/RPSV<2.0,正常人仅1/20(5%)例<2.0;CFR下降对冠心病的检出率除了运动SPECT心肌断层显像外均较其它无创检查法高。这些资料表明:经食管多普勒超声心动图可检出冠心病患者的CFR有明显减退,CFR下降可作为检出冠心病的一种无创性敏感检查方法。 相似文献
7.
本文对结扎冠状动脉前降支的实验动物与冠心病患者用多普勒超声心动图(PDE)作左室舒张功能测定,同时对实验动物作心导管测压。发现结扎前降支后LAP及LVEDP增高,—dp/dt下降,两组PDE均显示左室流入道正峰降低,A峰增高。其EDC的下降与梗塞心肌重量(动物组)相关佳;0.5A/TA及0.33A/TA,EDC的改变随病变血管数增多而下降显著(临床组)。故上述指标对冠心病的诊断与预后评定有一定价值。 相似文献
8.
采用彩色多普勒超声心动图描记术和常规心电图研究48例心功能NYHAI级的高血压和冠心病患者,经多因素逐步回归分析,发现常规心电图V1导联P波终末电势(PTFV1)主要与左房大小和E峰相关,Ⅱ导联P波时限与P-R段比值指数则是反映A峰和A/E改变的敏感指标。两方法联用对早期检测是否存在潜隐的左室舒张功能不全有价值。 相似文献
9.
应用二维多普勒超声心动图和常规心电图对64例高血压和冠心病患者的心功能进行分析研究,旨在探讨心电图PtfV1及Macruz指数与超声心动图左房室功能指标的相关性。结果发现心电图PtfV1和Macruz指数与左房功能指标LAD、LAV、LAP和LAT有显著线性相关意义(P<0.01),与左室舒张功能指标A峰、A/E比值、PFR及NPFR呈轻度线性相关意义(P<0.01)。结论认为对于心功能正常的高血压和冠心病患者,当心电图左房指标异常时,进一步结合超声心动图检查将有助于早期确定是否存在左室舒张功能不全,同时对全面客观地评价左房功能变化程度有重要意义。 相似文献
10.
多普勒超声心动图检测肺静脉及二尖瓣血流评价左室舒张功能 总被引:5,自引:0,他引:5
目的 探讨经胸多普勒超声心动图检测肺静脉血流频谱(PVFP)及二尖瓣血流频谱(MVFP) 的变化无创评价左室舒张功能的价值。方法 选择40 岁以上的无心脏疾患者30 例为对照组;高血压病左房不大组30 例;冠心病左房不大组30 例;高血压或冠心病左房扩大组30 例共120 例为研究对象。使用经胸多普勒超声心动图记录肺静脉及二尖瓣血流频谱,观察各组病人肺静脉及二尖瓣血流速度的变化和左室舒张功能的关系。结果 高血压或冠心病左房不大组与对照组比较,MVFP 中E 峰速度减低,E 峰减速时间延长,A 峰速度增高,E/A 比值减低。PVFP中S峰速度增快,SF增大,二组之间有明显差异( P< 001) ;高血压或冠心病左房扩大组与对照组比较PVFP中S峰速度减低,SF减低,PA 速度增快、间期延长,PAd > Ad( P< 001) ,而MVFP除EDT 缩短以外,E、A 峰速度、E/A 比值二者近似( P> 005) 。结论 超声心动图记录肺静脉及二尖瓣血流变化能够较全面地评价左室舒张功能。 相似文献
11.
Calin V Maniu Rick A Nishimura A Jamil Tajik 《Journal of the American Society of Echocardiography》2004,17(6):634-637
Alteration of the loading conditions during the Valsalva maneuver is a helpful ancillary method in the noninvasive assessment of diastolic filling of the heart by Doppler echocardiography. When tachycardia is induced by the maneuver, mitral inflow velocity curves may become uninterpretable because of E velocity (the initial early diastolic velocity on the transmitral flow velocity curve) and A velocity (the velocity at atrial contraction on the transmitral flow velocity curve) wave fusion. To determine the clinical significance of the E velocity and A velocity wave fusion, our study assessed the relation between the heart rate response induced by the Valsalva maneuver and the left ventricular filling pressures measured during cardiac catheterization. In all, 77 patients performed the maneuver during continuous hemodynamic and electrocardiographic monitoring. The ratio between the baseline R-R interval and the shortest R-R interval during the maneuver was calculated. A ratio value higher than 1.1 was predictive of a pre-A pressure of less than 18 mm Hg (94% positive predictive value). Reflex tachycardia during the Valsalva maneuver and subsequent fusion of the E velocity and A velocity waves on the mitral velocity curves is a sign of normal left ventricular filling pressures. 相似文献
12.
目的探讨做Valsalva动作是否可以鉴别假性正常的二尖瓣口舒张期血流频谱。方法在平静时二尖瓣口舒张期血流频谱形态正常的对照组33例,年龄(61.4±9.9)岁和可能为假性正常的心肌缺血组19例(其中8例为经冠状动脉造影证实为一支以上冠状动脉主支近端狭窄>75%,11例为陈旧性心肌梗塞,年龄(63.1±9.5)岁,比较两组在做Valsalva动作时的二尖瓣口舒张期血流频谱的E、A峰峰值流速,E/A,E峰减速时间(DT)和等容舒张期(IVRT)的变化。结果平静时两组间E、A、E/A和DT均无显著差异。假性正常组的IVRT略大于正常组(93±9)cm/s比(89±12)cm/s,P<0.05。做Valsalva动作时,两组E、A峰均降低,正常组E峰减低幅度小于假性正常化组(-22±11)cm/s比(-30±9)cm/s,P<0.01,而其A峰减低幅度大于假性正常化组(-9±14)cm/s比(-2±9)cm/s,P<0.05,两组E/A出现显著差别,1.3±0.2比0.9±0.2,P<0.01;两组DT(24±47)ms比(31±52)ms,P=NS、IVRT(11±11)ms比(13±15)ms,P=NS,变化幅度相近。结论做Valsalva动作,可以使二尖瓣口舒张期血流频谱正常组和假性正常组E、A、E/A发生不同的变化,可以用于两者鉴别。 相似文献
13.
Valsalva动作对评价左室舒张功能三种常用指标的影响 总被引:3,自引:1,他引:2
目的研究正常人Valsalva动作后前负荷降低是否引起舒张期二尖瓣口血流频谱、二尖瓣环运动速度及舒张早期左室血流传播速度三种指标变化以及如何变化。方法50例健康人,Valsalva动作前后分别测定舒张期二尖瓣口血流频谱、二尖瓣环运动频谱(DTI)和M型彩色多普勒舒张早期左室内血流传播速度(FPV),并进行Val-salva动作前后对照分析。结果Valsalva动作前后比较,舒张期二尖瓣口血流频谱E峰速度减低〔(80.6±16.3)cm/svs(65.9±13.3)cm/s,P<0.01〕,A峰速度、E/A比值减低〔(54.2±10.2)cm/svs(49.5±10.4)cm/s和1.51±0.23vs1.37±0.29,P<0.05),E峰减速时间DT延长〔(0.161±0.031)svs(0.192±0.05)s,P<0.01〕。侧壁处二尖瓣环运动速度Eal降低〔(18.7±3.8)em/svs(16.3±3.7)cm/s,P<0.01〕,Aal和Eal/Aal比值无显著变化〔(11.3±2.5)cm/svs(10.5±1.9)cm/s和1.72±0.46vs1.60±0.44,P>0.05〕,室间隔侧Eas、Aas降低〔(14.7±2.8)cm/svs(13.1±2.4)cm/s和(9.9±1.7)cm/svs(8.8±1.9)cm/s,P<0.01〕,Eas/Aas比值无显著变化(1.53±0.37vs1.54±0.33,P>0.05),FPV无显著变化〔(55.87±6.66)cm/svs(55.32±10.22)cm/s,P>0.05〕。结论作为评价左室舒张功能的指标,二尖瓣口血流易受前负荷影响,舒张期二尖瓣环运动速度与FPV相对不受前负荷影响,但二尖瓣环运动速度这一指标实际应用中更为优越。 相似文献
14.
H P Brunner-La Rocca H Rickli C H Attenhofer Jost R Jenni 《Journal of the American Society of Echocardiography》2000,13(6):599-607
We directly compared the transmitral inflow pattern during preload reduction and pulmonary venous flow velocities to determine left ventricular end-diastolic pressure (LVEDP) in 78 patients who underwent left heart catheterization. Transmitral inflow indexes (A-wave duration, ratio of peak flow velocity of early diastole [E] to peak flow velocity of late diastole during atrial contraction [A] [E/A ratio]) at rest and during the Valsalva maneuver (30 mm Hg for 15 seconds) and indexes of pulmonary venous flow (velocity and duration of the atrial reversal) were obtained. Fair correlations existed between LVEDP (mean 15+/-6 mm Hg) and the percentage decrease in the E/A ratio (r = 0.72), increase in duration of A wave during the Valsalva maneuver (r = 0.60), flow velocity of atrial reversal (r = 0.58), and difference of duration of atrial flow reversal and A wave (r = 0.62) (all P<.001). While sensitivity, specificity, and diagnostic accuracy to detect an elevated LVEDP were comparable, technically adequate Doppler recordings were obtained more often for the mitral inflow during the Valsalva maneuver than for the pulmonary venous flow (72 versus 66 patients, P< 0.05). 相似文献
15.
Summary. A paradoxical embolism due to right-to-left shunt through a patent foramen ovale (PFO) can be responsible for stroke and other ischaemic cerebral events. We studied the usefulness of saline contrast transoesophageal echocardiography after the Valsalva manoeuvre in detecting PFO and right-to-left shunts in 28 adult patients without known reason for a recent stroke. The results were compared with conventional transthoracic colour Doppler and with transoesophageal colour Doppler techniques. A PFO was found in 24 patients (86%) of our selected study population, whereas in four patients no PFO was found. A PFO with left-to-right shunt could be diagnosed by transthoracic colour Doppler echocardiography in only one case. A PFO with left-to-right shunt was found by transoesophageal colour Doppler echocardiography in 17 patients (61%), but in only three of them was a right-to-left shunt detected, even after the Valsalva manoeuvre. In contrast, a PFO with right-to-left shunt could be detected in 21 patients (75%) by using saline contrast transoesophageal echocardiography with the Valsalva manoeuvre. However, the method was unable to detect three cases of PFO with only left-to-right shunt, which were detected by colour Doppler transoesophageal echocardiography. In conclusion, our results show that saline contrast transoesophageal echocardiography with the Valsalva manoeuvre greatly improves the echocardiographic detection of PFO with right-to-left shunts in stroke patients. 相似文献
16.
Effect of Preload Alternations on a New Doppler Echocardiographic Index of Combined Systolic and Diastolic Performance 总被引:3,自引:0,他引:3
Jacob E. Mller MD Steen H. Poulsen MD PhD Kenneth Egstrup MD DMSci FESC 《Journal of the American Society of Echocardiography》1999,12(12):1065-1072
The objective of the study was to assess the effect of preload alternations on a nongeometric Doppler index of combined systolic and diastolic myocardial performance (MPI). Doppler echocardiography was performed during Valsalva maneuver, passive leg lifting, and after sublingual administration of nitroglycerin in 50 healthy volunteers (group 1) and 25 patients (group 2) with previous myocardial infarction. MPI was significantly lower in group 1 (0.34 +/- 0.04) compared with group 2 (0.52 +/- 0.14), P <.0005. In group 1 MPI was significantly increased during preload manipulations (P =. 001). The largest change in MPI was induced by nitroglycerin (0.034 +/- 0.05). In group 2 no significant changes in MPI were found. In both groups peak E-wave velocity (P <.0005), E/A-ratio (P <.0005), and E-wave deceleration time (P <.0005) were found to change during preload alternations. In conclusion, we found in normal subjects and to a lesser extent in patients with previous myocardial infarction that MPI is influenced by preload. 相似文献
17.
Triphasic mitral inflow velocity with middiastolic filling: clinical implications and associated echocardiographic findings. 总被引:2,自引:0,他引:2
Jong-Won Ha Jae K Oh Margaret M Redfield Keiji Ujino James B Seward A Jamil Tajik 《Journal of the American Society of Echocardiography》2004,17(5):428-431
To explore underlying mechanisms and clinical implications of middiastolic filling, we measured early and late mitral inflow velocities, deceleration time of early mitral inflow velocity, and early diastolic mitral annular velocity (E') recorded by pulsed wave Doppler echocardiography in 3 cardiac cycles of 35 patients with prominent mitral inflow (middiastolic flow velocity > or = 0.2 m/s). E' was measured at the septal corner of the mitral annulus by Doppler tissue echocardiography from the apical 4-chamber view and was found to be reduced (E' < 0.1 m/s) in all patients; early mitral inflow velocity/E' ratio was > 10 in all but 1 patient. Valsalva maneuver unmasked delayed relaxation in 15 (88%) of 17 patients and abolished middiastolic filling in 10 (59%). Triphasic mitral inflow with middiastolic flow is related to elevated filling pressure, delayed myocardial relaxation, and slow heart rate, indicating advanced diastolic dysfunction. 相似文献
18.
经颅多普勒超声诊断脑梗死患者卵圆孔未闭的价值 总被引:1,自引:0,他引:1
目的探讨经颅多普勒超声微泡实验对脑梗死患者卵圆孔未闭(PFO)的诊断价值。方法运用经颅多普勒超声微泡实验对经食管超声心动图诊断的28例缺血性脑卒中患者进行PFO检测,分析不同卵圆孔特点下经颅多普勒超声微泡实验对PFO诊断检出率的变化。结果 28例患者中,经颅多普勒超声微泡实验在平静呼吸状态下对PFO检出20例(71.43%),配合Valsalva动作后检出24例(85.71%)。卵圆孔大小及开放状态与PFO的检出率无关(P>0.05)。结论经颅多普勒超声微泡实验对脑梗死患者的PFO的诊断具有较高敏感性,配合Valsalva动作可以提高诊断敏感性,可以作为PFO的筛查手段。 相似文献
19.
组织多普勒Tei指数评价冠心病左室功能 总被引:2,自引:0,他引:2
目的探讨组织多普勒(TDI)Tei指数评价冠心病患者左室功能的价值。方法经胸超声检测冠心病患者和正常人各31例,测量左室射血分数(EF)、左室缩短分数(FS),二尖瓣口舒张早期血流(E峰)和舒张晚期血流(A峰)比值,测量a时间、b时间,计算传统Tei指数(C-Tei);应用TDI获取二尖瓣环侧壁处的运动频谱,测量运动速度及时间间期a’、b’,计算TDI-Tei指数,并与C-Tei指数比较。结果冠心病患者左室TDI-Tei指数较正常值明显增大(P<0.01),C-Tei指数也较正常值明显增大(P<0.01),但小于TDI-Tei指数(P<0.05)。结论TDI-Tei指数用于评价冠心病患者左室功能较传统的C-Tei更为敏感和准确。 相似文献
20.
Ogata T Yasaka M Nagatsuka K Yamamura O Minematsu K 《Ultrasound in medicine & biology》2006,32(3):339-343
Nonsmoke spontaneous individual contrast (NSSIC) is a phenomenon that is a contrast effect appearing from the right pulmonary vein to the left atrium just after a Valsalva maneuver in a transesophageal echocardiography study without administration of any contrast medium. The goal of this study was to characterize factors associated with occurrence of NSSIC. Transesophageal echocardiography was performed in 228 consecutive patients to determine the presence or absence of the patent foramen ovale and valvular disease and various patient characteristics and laboratory data. NSSIC was demonstrated in 109 (47.8%) of 228 patients. Factors associated with occurrence of NSSIC included younger age, male gender, smoking habit, taller height, heavier weight, higher hematocrit, higher plasma level of fibrinogen, lower D-dimer levels and presence of mitral valve strand. Multiple logistic regression analysis indicated that higher hematocrit and plasma levels of fibrinogen were most closely associated with the presence of NSSIC. Thus, NSSIC may occur secondary to specific blood rheologic factors during the Valsalva maneuver. 相似文献