多普勒组织成像在心肌梗死患者经皮冠状动脉介入术后的临床应用

目的研究多普勒组织成像（DTI）技术用于心肌梗死（MI）患者经皮冠状动脉介入术（PCI）术后心功能随访的可行性。方法选择86例MI住院患者,根据是否进行PCI术,分为PCI组45例和常规治疗组41例,术前、术后1个月、6个月、12个月行DTI及常规超声心动图检查。结果PCI术后,左室射血分数（EF）及应用DTI技术检测二尖瓣环四点（室间隔、侧壁、前壁、下壁）收缩期主峰S波速度的平均值术后1个月较术前即有明显改善,S波速度与EF之间的相关性较好,且比EF的敏感性更高。DTI二尖瓣环四点的舒张早期与晚期主峰速度e/a比值的平均值术后较术前增大;常规超声心动图二尖瓣口血流舒张早期与晚期主峰速度E/A比值无显著性差异。结论PCI术后,患者整体心脏收缩、舒张功能短期内得到改善;DTI技术观测AMI患者的心功能较常规超声心动图技术敏感性及特异性均高,可作为常规超声心动图的有力补充。

Application of Doppler Tissue Imaging in Assessment of Cardiac Function of Patients after Percutaneous Coronary Intervention for Myocardial Infarction: One Year Follow-up

Objective To evaluate the application of Doppler tissue imaging (DTI) in assessment of cardiac function after percutaneous coronary intervention (PCI) for myocardial infarction (MI) for long term follow-up. Methods 86 patients with MI were divided in PCI group (45 cases) and conventional therapy group (41 cases). All the patients received two-dimensional echocardiography (2DE) and DTI measurements. The left ventricular ejection fraction (LVEF), peak E, peak A wave velocities and peak E versus peak A (E/A) of 2DE were recorded, as well as the velocity of systolic wave(s), early diastolic filling wave(e), late filling wave(a) and wave e versus wave a (e/a ) of DTI. Results The LVEF and the average velocity of systolic wave (s) of mitral annulus was increased after PCI (P<0.05). S wave was related to LVEF, but the sensitivity of s wave is better than that of LVEF. There was no difference in the pulse Doppler trans mitral flow velocity E/A before and after PCI (P>0.05) , but the average velocity of mitral annulus (e/a ) was remarkably increased after PCI (P<0.01).Conclusion The left ventricular systolic and diastolic function in MI patients be improved after PCI. DTI is a sensitive method to detect the cardiac function after MI and PCI.