多普勒组织成像定量分析155例冠心病左心室局部收缩和舒张功能

目的 应用多普勒组织成像（ＤＴＩ）技术定量定位分析生理和病理（心肌缺血）状态下左心室局部收缩和舒张功能。方法 研究对象为１５５例确诊冠心病的患者（冠心病组）和４１例年龄匹配的正常人（对照组）。采用心尖四腔、心尖二腔和心尖长轴切面，每个室壁又选择两个取样点分别位于该室壁的基底部和中部，分别显示左心室６个室壁１２个节段运动的情况。ＤＴＩ测量参数包括收缩功能指标：心肌收缩峰值速度（Ｖｓ）和ＶＥ与舒张晚期峰值速度（ＶＡ）的比值（ＶＥ／ＶＡ）。结果 与对照组相比，冠心病组ＤＴＩ可敏感地定量显示出收缩和舒张峰值速度显著下降以及峰值时间的显著延长；前壁心肌梗死时可见病变区多个节段多项ＤＴＩ收缩和舒张功能参数异常，ＤＴＩ收缩与舒张速度指标之间、收缩速度与左室射血分数之间以及舒张功能参数ＶＥ／ＶＡ均值与二尖瓣血流频谱Ｅ／Ａ比值之

Quantitative analysis of regional left ventricular systolic and diastolic function in 155 coronary artery disease by Doppler tissue imaging

Objective To quantitatively assess regional left ventricular(LV) systolic and diastolic function in physiological and pathological(myocardial ischemia) condition by Doppler tissue imaging(DTI) technique.Methods One hundred and fifty five patients with coronary artery disease (CAD) and 41 age matched healthy subjects as control group were included. Apical 4 chambers, 2 chambers and long axis views were performed with pulsed sample volume at the basal and middle levels,which could show 12 segments of 6 LV walls. Peak systolic velocity (V S), time to peak systolic velocity(T S), peak early diastolic velocity(V E), time to peak diastolic velocity(T E), and peak late diastolic velocity(V A) were measured in each segment and V E/V A ratio was calculated.Results Compared with control group, decreased V S, V E, and diastolic velocities and delayed time to peak velocity were sensitively detected by DTI in CAD group. In the case of anterior wall infarction DTI showed abnormal systolic and diastolic indexes in the involved segments.Also, there were close relations between DTI systolic and diastolic indexes, between DTI systolic indexes and LVEF(M mode), and between V E/V A(mean) and transmitral indexes E/A ratio.Conclusion As a new method of quantitatively assessing regional LV function, DTI has a potential value in the non invasive diagnosis of CAD.