TDI技术定量评价经皮冠状动脉成形术前后左心室局部与整体的收缩功能

目的 :用组织多普勒成像 (tissue Doppler imaging,TDI)技术评价经皮冠状动脉成形术 (PTCA)前后左心室局部与整体收缩功能的变化。 方法 :对 33例择期行 PTCA+支架术的冠心病患者用 HP5 5 0 0型超声诊断仪 ,于 PTCA术前及术后3d、1～ 3个月对胸骨旁左心室乳头肌短轴切面的前间壁、下壁、后壁、侧壁行二维超声心动图 (2 DE)检测各节段的室壁运动情况 ,用脉冲组织多普勒成像 (PW- TDI)检测上述各节段的内、外膜下及中层心肌的收缩期峰值速度 (Ven、Vep、Vm) ,内外膜下心肌的收缩速度差 (Ven- Vep)及心尖四腔观二尖瓣外侧环的收缩期峰值速度。结果 :术后 3d左心室节段运动恢复 ,局部各层心肌收缩期峰值速度有所增加 ,内外膜下心肌的收缩速度差略下降 ,左心室二尖瓣环收缩速度于术后 3d有所增加 ,但均无统计学意义。术后 1～ 3个月 ,各层心肌的收缩期峰值速度、内外膜下心肌收缩速度差较术后 3d均明显增加 (P<0 .0 5 ) ,左心室二尖瓣环收缩速度亦明显增加 (P<0 .0 5 )。 结论 :TDI能较准确地定量检测 PTCA前后左室局部与整体功能 ,为临床评价PTCA疗效提供了新的定量评价指标和信息

Quantitative evaluation of regional and global left ventricular systolic function before and after percutaneous transluminal coronary angioplasty by tissue Doppler imaging

Objective:To quantitatively evaluate the regional and global left ventricular systolic function before and after percutaneous transluminal coronary angioplasty(PTCA) by tissue Doppler imaging(TDI). Methods: The motion of parasternal papillary muscle anterior wall, inferior wall, posterior wall, and lateral wall were detected by 2DE at short axis view of left ventricle before PTCA, 3 d and 1 3 months after PTCA in 33 cases of patients with coronary heart disease, who received PTCA+stent at selected time.Peak systolic velocity of subendocardial,subepicardial and middle layer myocardium (Ven,Vep,Vm), transmural velocity difference(Ven-Vep) of the same segments and outer lateral mitral valve annulus were also detected at apical 4 chamber view by pulsed wave tissue Doppler imaging(PW TDI).Results: The myocardium wall motion recovered 3 d after operation, systolic velocity of regional myocardium and mitral valve annulus had little increase (but had no statistical significance, P >0.05) and systolic velocity of regional myocardium, the difference between Ven and Vep, and mitral valve annulus have improved during the follow up study( P <0.05). Conclusion: PW TDI can quantitatively detect regional and global systolic function and can provide new quantitative indices and messages for evaluating the effect of PTCA.