组织多普勒成像技术对射血分数正常的心衰患者左室收缩功能评价

目的探讨射血分数正常的心衰患者左心室长轴收缩功能的变化特点。方法观察Ⅰ组为30例正常人及符合心衰标准患者90例,按照射血分数不同分为3组:Ⅱ组30例(EF<40%)、Ⅲ组30例(40%≤EF≤50%),Ⅳ组30例(EF>50%),采用组织多普勒成像(DTI)在二尖瓣5处测量心肌长轴方向的收缩期峰值速度(Sm)、收缩期位移(DSm)、等容收缩期(IVCTm)、舒张早期峰值速度(Em)和心房收缩峰值速度(Am)、等容舒张期(IVRTm),比较各组TDI指标变化规律及特点。结果收缩功能指标Sm、DSm在Ⅰ组、Ⅳ组、Ⅲ组、Ⅱ组呈逐渐减小趋势,而IVCTm呈逐渐延长趋势(各组之间比较P<0.05);IVRTm在Ⅰ组、Ⅱ组、Ⅲ组、Ⅳ组呈逐渐延长趋势(各组之间比较P<0.05),Em/Am各组之间无统计学意义。E/Em与Sm显著相关,相关系数r=-0.409,P=0.025。结论射血分数正常的心衰患者与正常人相比存在长轴收缩功能减低,但其受损程度较射血分数减低的心衰患者轻。收缩功能与舒张功能是一个连续的、密不可分的过程。

Evaluation of Left Ventricular Systolic Function by Tissue DopplerImaging in Patients of Heart Failure with Normal Ejection Fraction

Objective To analyze the variation of left ventricular systolic function in the patients of heart failure with normal ejection fraction. Methods 30 healthy individuals （Group I ） was selected together with 90 patients of heart failure which were divided into three groups, i.e.30 patients with EF〈 40% （Group Ⅱ ）, 40% ≤EF≤〈50% （Group m ） and EF 〉 50% （Group Ⅳ ） respectively.Tissue Doppler imaging （TDI） was performed to measure the flow velocity of 5 sites in long axis of the mitral annular systolic peak velocity （Sm）, the systolic displacement （DSm） and the isovo- lumic contraction time （IVCTm）, early diastolic velocity （Em） and peak velocity of trans - mitral flow by atrial contrac- tion （Am）, and the isovolumic relaxation（IVRTm）.On the basis, the parameters of TDI in various groups were com- pared. Results The parameter Sm and DSm decreased, and IVCTm increased gradually in Group Ⅰ ,Ⅳ, Ⅲ and Ⅱ （ P 〈0.05 between various groups）.IVRTm increased gradually in Group Ⅰ ,Ⅱ ,Ⅲ and Ⅳ（ P 〈0.05 between vari- ous groups）, and Em/Am had no significant difference among those groups. E/Em and Sm had obvious relativity, and the relative coefficients r = - 0.409, p = 0.025. Conclusion Compared with healthy individuals, the patients of heart failure with normal ejection fraction might have systolic dysfunction in left ventricular long- axis, but the injury is not so severe than those of abnormal ejection fraction. Systolic function had significant relativity to diastolic function.