组织多普勒速度成像定量测量瓣环运动速度评价缩窄性心包炎患者术后心功能改变

目的 应用组织多普勒技术定量评价缩窄性心包炎(CP)患者手术治疗后心脏收缩、舒张功能改变。 方法 选取已确诊为CP且择期接受CP心包剥脱术的患者22例,于手术前及术后1个月分别行超声检查,存储心尖四腔心、心尖两腔心及心尖部左心室长轴切面组织多普勒二维图像,以定量组织多普勒技术分析并记录二尖瓣环各部位及三尖瓣环侧壁收缩期及舒张期峰值运动速度(S'、E'),分别计算各个节段S'、E'及三尖瓣环的平均速度作为二尖瓣环的总体运动速度。 结果 CP患者术后1个月左心室变大(P<0.001),左心房(P=0.011)及右心房(P=0.004)呈不同程度缩小,左心室射血分数增高(P=0.021);三尖瓣环、二尖瓣环左心室侧壁及室间隔S'、E'均有不同程度减低(P均<0.05),三尖瓣环、二尖瓣环S'、E'峰亦有不同程度减低(P均<0.01)。 结论 CP患者术后左心室射血分数增加,心脏各腔室发生趋于正常的重构;术后短期内切除心包瓣环部位S'及E'较术前减低,表明左心室壁纵向运动速度减低。

Doppler tissue velocity imaging in quantitative evaluation on postoperative changes of heart function with measurement of valve annulus velocity in constrictive pericarditis patients

Objective To observe the changes of constrictive pericarditis (CP) patients after pericardiectomy with quantitative tissue velocity imaging (QTVI). Methods Totally 22 CP patients who underwent pericardiectomy were enrolled. Echocardiography were performed before and after pericardiectomy. Tissue Dopplor images of two chambers, four chambers and long axis at apex view were stored. The systolic and diastolic peak velocity (S', E') of mitral segments and tricuspid annular were analyzed by quantitative tissue Doppler technology. The globle velocity of mitral annular was defined as the mean of mitral annular segments. Results The diameter of left ventricular increased (P<0.001), of left (P=0.011) and right atrium (P=0.004) decreased at different degrees, while left ventricular ejection fraction increased (P=0.021), and the systolic and diastolic average velocity S', E' of mitral and tricuspid annular decreased after pericardiectomy (all P<0.05). The globle velocity of mitral and tricuspid annular became lower after pericardiectomy (all P<0.01). Conclusion Left ventricular ejection fraction increase, and reconstruction of the atrium and ventricular are towards normal after pericardiectomy in CP patients. S' and E' of segments which pericardium stripped become lower after pericardiectomy, indicating longitudinal movement of left ventricular decrease in the short term.