非体外循环冠状动脉旁路移植术前后左心室长轴功能的变化

目的 运用组织多普勒成像（TDI）技术测定非体外循环冠状动脉旁路移植（OPCAB）术前后左心室长轴功能的变化，并探讨其临床意义。方法 应用TDI技术测定48例冠心病病人在OPCAB术前、术后1周和术后3月二尖瓣环收缩期心肌峰值运动速度（SM）和位移（DS）及收缩前期时间（PCTM），舒张早期心肌峰值运动速度（EM），心房收缩期心肌峰值运动速度（AM），计算EM／AM比值。结果 与OPCAB术前比较，SM在术后1周和术后3月明显增加（F=9．80，q=3．53、9．27，P〈0．01）；Ds在术后1周和术后3月明显增加（F=7．74，q=4．45、7．81，P〈0．01）；PCTM在术后1周和术后3月显著减小（F=6．21，q=3．18、6．11，P〈0．01）；EM在术后1周和术后3月显著增加（F=10．72，q=9．86、11．21，P〈0．01）；EM／AM比值在术后1周和术后3月显著升高（F=9．12，q=3．12、8．34，P〈0．01）。结论 左心室长轴功能在OPCAB术后1周明显改善，并且随时间推移进一步改善，TDI为准确评价OPCAB术前后左心室长轴功能的变化提供了一条新途径。

ALTERATION OF LEFT VENTRICULAR LONG-AXIS FUNCTION FOLLOWING OFF-PUMP CORONARY ARTERY BYPASS

Objective To measure the left ventricular long-axis function,using tissue Doppler imaging(TDI),in patients before and after off-pump coronary artery bypass(OPCAB) and to investigate its clinical significance. Methods Long-axis function parameters were measured using TDI in 48 patients before and 1 week and 3 months after OPCAB in mitral annulus level, including peak systolic velocity(S_M) and excursion(D_S),the time interval from ECG Q wave to S_M(PCT_M),early diastolic peak velocity(E_M),late diastolic peak velocity(A_M) and E_M/A_M. Results S_M was higher after OPCAB than before(F=9.80,q=(3.53),9.27;P<0.01);D_S increased after OPCAB(F=7.74;q=4.45,7.81;P<0.01);PCT_M decreased(F=6.21;q=3.18,(6.11;)P<0.01);E_M increased(F=10.72;q=9.86,11.21;P<0.01);E_M/A_M increased(F=9.12;q=3.12,8.34;P<0.01). Conclusion Left ventricular long-axis function improved one week after OPCAB.TDI provides a new way to evaluate left ventricular long-axis function before and after OPCAB.