多普勒组织成像对高血压左心室肥厚患者左心室舒张功能的评价

目的 应用多普勒组织成像（DTI）技术评价高血压左心室肥厚患者左心室舒张功能，并与二尖瓣血流频谱作对比。方法 研究对象为35例临床与超声诊断的高血压左心室肥厚患者（高心组）和20例正常人（对照组）。采用心尖四腔观，选取室间隔中段，左室侧壁中段，二尖瓣环-室间隔交界处、二尖瓣环一侧壁交界处为取样点，分别显示各部位组织的运动情况，并测量心肌收缩峰速度（Vs）、心肌舒张早期峰值速度（Ve）、舒张晚期峰值速度（VA）及VE与VA比值（VE/VA）。常规测量二尖瓣血流频谱，与DTI参数作对比。结果 与对照组相比，高心组室间隔中段，侧壁中段、二尖瓣环VE、VE/VA均显著下降，各部位VE/VA均与二尖瓣血流频谱E/A之间存在高度相关性；DTI对高血压左心室肥厚患者左心室舒张功能异常的诊断灵敏度高于二尖瓣血流频谱。结论 DTI技术可以定量评价高血压左心室肥厚患者的左心室舒张功能，并且比常规脉冲波多普勒二尖瓣血流参数更加敏感。

Assessment of left ventricular diastolic function in patients with hypertension and left ventricular hypertrophy by Doppler tissue imaging

Objective To assess left ventricular diastolic function in patients with hypertension and left ventricular hypertrophy(LVH) by Doppler tissue imaging(DTI) technique.Methods Thirty five patients with hypertension and LVH and 20 age matched healthy subjects as control group were included. Mitral valve flow spectra and pulmonary vein flow spectra were measured by pulsed Doppler ultrasound. DTI data were acquired from medium segments of interventricular septum and lateral wall as well as septum and lateral mitral anulus on apical four chamber views.Results Compared with control group, LVH group had lower peak early diastolic velocity (V E) and decreased V E/peak early diastolic velocity (V E/V A) ratio. There was no significant difference in systolic myocardial velocity between two groups. DTI diastolic index V E/V A was closely correlated to transmitral index E/A ratio.Conclusions DTI may be clinically useful in detecting LV diastolic dysfunction in patients with hypertension and LVH, especially in detecting a pseudonormalization pattern of mitral inflow.