组织多普勒显像对缺血心肌局部舒张功能的评价

目的组织多普勒显像（TDI）评价缺血心肌局部舒张功能的价值。方法超声心动图记录心肌缺血舒张期二尖瓣血流频谱（TMF）及左室基底部、中部和心尖部3个水平面15节段TDI。结果两组间左室射血分值相近；心肌缺血(Is)组TMF舒张早期减速度时间和等容舒张时间延长（P<0.01），E/A比值增加（P<0.01）；对照(Con)组TDI示左室基底部与中部心肌舒张早期舒张速度（Em）高于心尖部（P<0.05），缺血节段Em降低，局部早期舒张减速度时间和等容舒张时间延长；Is组异常显示率TDI高于TMF(93％64％，P<0.01)。结论TDI可无创检测左室局部舒张功能；缺血心肌呈舒缓异常，其异常出现率高于TMF。

Diagnostic effects of regional distolic function in ischemic myocardium with tissue Doppler imaging

Objective To assess the regional diastolic function of myocardial ischemia with tissue Doppler imaging,compare with c oronary artery angigraph.Method Global and reginal isovalumic relax ation time (IRT,IRTm),deceletation time of early filling(DCT,DCTm),early distolic velocity(E,Em),late distolic velocity(A,Am),E /A and mE /mA were measured by pulse d Doppler echocardiography and TDI re-spectively.Result There were not difference in LVEF between Is and Con -group Compared with Con,DCTm and IRTm were prolonged(P<0.01).The Em of basal and middle level of left ventricle were higher than apical level in Con -group;The slower Em,lo nger IRTm and DCTm were found in ischemic segments.We showed higher abnormal rate in Is-group(P<0.01)by comparison with transmitral flow.Conclution TDI can non -invasive evaluate the re gional diastolic function of ischem ic myocardium.It is a valid and sensitive method for detecting of cardiac diastolic function of coronary artery disease.