组织多普勒成像评价老年单纯舒张功能不全患者左心室收缩功能的变化

目的采用组织多普勒(TDI)成像技术评价老年单纯舒张功能不全患者左心室长轴收缩功能的变化。方法选取老年无症状舒张功能不全患者(老年ADD组)157例、老年舒张性心力衰竭患者(老年DHF组)130例及健康老年人(正常对照组)89例,应用TDI成像技术测量二尖瓣环水平左心室室间隔、侧壁、前壁、下壁心肌长轴方向收缩期心肌峰值运动速度(Sm);Simpson法测量左心室射血分数(LVEF)。结果与正常对照组比较,老年ADD组与老年DHF组二尖瓣环水平心肌侧壁、前壁、下壁Sm值、Sm均值及老年DHF组室间隔Sm值显著降低(P<0.05~0.001),且老年DHF组Sm值降低幅度更大(P<0.05~0.001)。结论老年单纯舒张功能不全患者存在左心室长轴收缩功能降低,Sm较LVEF能更敏感地检测到轻度收缩功能不全的存在。

Evaluation of changes of systolic function of left ventricle in the old patients with isolated diastolic dysfunction by tissue Doppler imaging

Objective To evaluate the changes of longitudinal axis systolic function in the old patients with isolated diastolic dysfunction by tissue Doppler imaging.Methods Ultrasonocar diography(UCG) was performed for the following groups: 157 elderly asymptomatic diastolic dysfunction(ADD) patients,130 elderly diastolic heart failure(DHF) patients and 89 senile healthy volunteers. LVEF was measured with Simpson's biplane method.Tissue Doppler imaging(TDI) was performed at the interventricular septum and lateral,anterior and inferior wall of left ventricle for measuring the peak regional myocardial sustained systolic (Sm) velocities.Results Compared with the healthy volunteers group,Sm at lateral,anterior and inferior wall at mitral annulus level and the mean Sm in the elderly ADD and DHF patients and sm at interventricular septum of the elderly DHF patients decreased(P<0.05-0.001),the decrease was especially significant in elderly DHF patients(P<0.05-0.001).Conclusion Isolated diastolic dysfunction is associated with decline in longitudinal axis systolic function of left ventricle.Sm evaluated by TDI is better than LVEF in detecting the existence of the slight systolic dysfunction.