定量组织多普勒评价急性下壁心肌梗死患者右室壁运动

目的 探讨定量组织多普勒成像技术(QTVI)评价急性心肌梗死患者(AMI)右室壁运动速度及心肌同步性运动的价值.方法 A组为正常对照26例,B组为急性下壁或下后壁心肌梗死急诊行经皮冠状动脉介入术(percutaneous coronary intervention PCI)后1周内患者24例,应用QTVI获得右室游离壁基底段﹑中段心肌的组织多普勒速度曲线,分别测量各阶段的收缩期(Vs)﹑舒张早期(Ve)﹑舒张晚期(Va)运动速度﹑收缩期S波持续时间(ET)及Ve/Va比值,同时测量各节段自QRS波起始至心肌收缩期及舒张早期峰值速度的时限收缩期同步性指标(Ts)和舒张期同步性指标(Te).结果 B组右室游离壁基底段﹑中段的Ve均较A组显著减小(均P＜0.01),基底段的ET及中段的Ve/Va比值均较A组减小(均P＜0.05),B组右室游离壁内各节段间的Ts和Te无差别(P＞ 0.05).结论 QTVI可简便﹑敏感地评价急性心肌梗死患者右室壁运动异常,AMI患者急诊行PCI术后右室游离壁内各节段收缩和舒张同步.

Quantitative tissue velocity imaging evaluation of right ventricular wall motion in patients with acute myocardial infarction

Objective To investigate the value of QTVI for estimating the velocity of segmental movement and intraventricular synchronity of RV in patients with AMI.Methods Twenty-six healthy subjects as group A and twenty-four patients with acute inferior or inferior-posterior infarction as group B were involved.The regional velocity profiles with QTVI of the basal and median segments of RV free wall were obtained.Vs,Ve,Va,ET,the synchronized time from QRS beginning to systole(Ts) or to diastole(Te) were measured with QTVI.Results In group B,all Ve were decreased obviously than those of A group(all P<0.01).ET of the basal segment and Ve/Va ratio of the median segment of RV free wall were lower than those in group A(P<0.05).Ts and Te within the two segments of RV had no significant differences in group B(P> 0.05).Conclusion QTVI was valuable and easy for evaluating the abnormal motion of RV free wall with high sensitivity.The systolic and diastolic movements were highly synchronized in RV free wall in group B after PCI operation.