多普勒超声心动图4种检测方法评价左室舒张功能

目的　应用二尖瓣血流频谱、肺静脉血流频谱、彩色M型多普勒超声心动图 (CMM)和组织多普勒图像 (DTI)等 4种方法评价左室舒张功能 ,并对其结果进行比较。　 方法　使用 4种多普勒超声心动图方法测定的相应数值评价正常组 (3 0例 )、高血压组 (3 0例 )及心肌梗死组 (2 7例 )的左室舒张功能的情况。　 结果　 (1)二尖瓣血流频谱表明高血压组左室舒张功能异常表现为松弛减退 (E/A <1) ;(2 )心肌梗死组E/A值与正常组比较无明显差异 ,肺静脉舒张末逆流峰值 (AR)明显增大 ,CMM测定的舒张早期血流传导速度 (FPV)明显减小 ,DTI测定的负向舒张早期波 (Ea)及Ea与负向舒张晚期波 (Aa)的比值 (Ea/Aa)与其他 2组比较P均 <0 0 1。　 结论 　评价左室舒张功能异常时 ,二尖瓣血流频谱能及早发现松弛减退 ,在可能存在假性正常时 ,综合应用AR、FPV、Ea、Ea/Aa可予以识别。考虑到经胸途径检查肺静脉往往比较困难且费时较多 ,而FPV、Ea、Ea/Aa测定简便易行 ,是综合评价左室舒张功能的有用指标。

Comparing four kinds of doppler echocardiography in assessment of left ventricular diastolic function

Objective To compare four kinds of Doppler echocardiography in the evaluation of left ventricular diastolic function. Methods Trans mitral velocity,pulmonary venous(PV) velocity,early diastolic flow propagation velocity(FPV) and mitral annulus velocity were measured by four kinds of echocardiography in 30 patients with hypertension,27 patients with post myocardial infarction and 30 control subjects. Results (1)trans mitral blood flow spectrum showed E/A<1 in patients with hypertension and some patients with post myocardial infarction,while E/A>1 in control subjects and other patients with post myocardial infarction.(2)PV systolic to diastolic(S/D) ratio was>1 in all groups.The PV artrial reversal flow velocity (AR) was higher and FPV,Ea,Ea/Aa was lower in patients with post myocardial infarction compared with other groups. Conclusions Doppler echocardiography may be regarded as the principal clinical tool for the assessment of left ventricular diastolic function.Patients with hypertension and coronary artery disease typically show a Doppler pattern of "delayed relaxation".AR,FPV,Ea and Ea/Aa may be useful in distinguishing a Doppler parttern of "pseudonormaligation".