心肌速率阶差无创评价左室舒缩功能的临床研究

目的　探讨心肌速率阶差MVG评价左室舒缩功能的价值。方法　扩张型心肌病患者 (DCM组 ) 2 0例 ,高血压患者 (HBP组 ) 2 5例 ,正常对照组 2 0例均行常规二维及脉冲多普勒超声心动图 (PW )和多普勒组织成像技术 (DTI)检查。常规超声获得左室射血分数 (EF) ;PW获得二尖瓣口血流速率E/A及E峰下降时间 (DcT) ;运用脉冲DTI于左室乳头肌短轴切面测量左室后壁心内膜下、心外膜下心肌运动速度VS心内膜下 、VS心外膜下 、VE心内膜下、VE心外膜下 ,并计算MVGS、MVGE。结果　与正常组比较 ,DCM组EF显著降低 ,DcT显著缩短 ,E/A显著增高 ;HBP组EF与正常组间无差异 ,E/A显著减低 ,DcT显著延长。与正常组比较 ,DCM组MVGS、MVGE 显著较低 ;HBP组MVGS 与正常组无差异 ,而MVGE 则显著较低。结论　脉冲DTI测量心肌速率阶差MVG可早期、无创、准确地反映心脏收缩、舒张功能。

Clinical Study of Myocardial Velocity Gradient as a Noninvasive Indicator of Left Ventricular Systolic or Diastolic Function

Objective To analyze the clinical value of peak myocardial velocity gradient (MVG) as a noninvasive indicator of left ventricular (LV) systolic or diastolic function. Methods Two dimensional and pulsed wave Doppler echocardiography (PW) and Doppler tissue imaging (DTI) were performed in 20 patients with dilated myocardium (DCM), 25 patients with hypertension (HBP) and 20 healthy controls. Two dimensional and PW indices included ejection fraction (EF), E/A and deceleration time of early diastolic filling E(DcT). Pulsed wave DTI indices included peak myocardial velocity gradient in systole (MVG S) and early diastole (MVG E). Results Compared with the healthy controls, the DCM group significantly decreased in EF and DcT, but increased in E/A; the HBP group had no significant difference in EF but significantly decreased in E/A and increased in DcT. The DCM group significantly decreased in MVG S and MVG E, while the HBP group significantly decreased in MVG E but no significant difference in MVG S. Conclusion Peak MVG derived from PW DTI is an early, noninvasive and adequate indicator of LV systolic or diastolic function.