脉冲组织多普勒定量分析冠心病患者左室局部收缩功能

目的应用脉冲组织多普勒成像(DTI)定量分析冠心病患者左室局部收缩功能,比较心肌梗死(心梗)与非心梗患者室壁运动变化的异同,评价收缩速度和时间指标检测室壁运动异常的价值。方法冠心病非心梗组16例、前壁心梗组21例,对照组16例。记录左室侧壁、间隔、前壁和下壁基底段及中段心肌运动频谱。DTI检测指标心肌收缩峰值速度(s)、局部射血前时间(PEP)、心肌收缩峰值时间(Ts)、局部射血时间(ET)、PEP/ET。结果前壁心梗组所有节段、非心梗组侧壁和前壁节段s均显著降低;前壁心梗组较非心梗组、梗死节段较非梗死节段s也显著降低。冠心病两组PEP、Ts显著延长。结论DTI所测s、PEP和Ts可敏感反映冠心病患者左室局部收缩功能异常;s还可反映心肌缺血损害的严重程度,有助于确定心梗部位。

Pulsed Doppler Tissue Imaging for Quantitative Analysis of Regional Left Ventricular Systolic Function in Patients with Coronary Artery Disease

Objective To quantitatively analyze regional left ventricular systolic function in patients with coronary artery disease(CAD) using pulsed Doppler tissue imaging(DTI),to compare the differences of longitudinal myocardial motion of the left ventricle between patients with and without myocardial infarction(MI),and to explore the value of systolic velocity and time intervals in detecting wall motion abnormalities.Methods Patients with CAD were divided into non-MI (16 cases) and anterior MI (ant-MI,21 cases) groups.Sixteen age-matched normal subjects served as the control group.The septum and lateral,anterior and inferior wall of the left ventricle were displayed,respectively,and basal and middle segments of each wall were selected for myocardial motion spectrum sampling.DTI parameters were:peak systolic myocardial velocity (s),regional pre-ejection period (PEP),time to the peak of s wave (Ts),regional ejection time (ET) and PEP/ET ratio.Results Compared with the control group,s was significantly lower in all segments in ant-MI group,and lateral and anterior segments in non-MI group.s was even lower in ant-MI than that of non-MI group,and in infarct compared with corresponding non-infarct segments in ant-MI group.PEP,Ts were significantly longer in CAD groups.Conclusions S,PEP and Ts measured by DTI may be the sensitive markers of regional left ventricular systolic dysfunction in patients with CAD,s value may indicate the severity of myocardial ischemia and aid in defining the site of MI.