组织速度成像技术评价慢性阻塞性肺疾病患者右室舒张功能

目的使用定量组织速度成像技术（Quantitative tissue velocity imaging,QTVI）评价慢性阻塞性肺疾病（COPD）患者的右室舒张功能。方法 COPD（缓解期）患者39例,按FEV1/FVC及FEV1/pre%分为轻度（I组）、中度（II组）、重度（III组）各13例。正常对照组20例。所有患者进行常规超声心动图和QTVI检查,并测量右室游离壁舒张期厚度（RVDT）、右室舒张期横径（RVDD）、主肺动脉内径（MPA）、三尖瓣下舒张血流充盈E/A比值、肺动脉收缩压（SPAP）、舒张早期峰值速度（Em）、舒张晚期峰值速度（Am）,取其平均值,并依据公式计算心肌运动指数（MPI）。所有测值与20例正常人各项超声指标对比分析。结果常规超声心动图显示COPD各组RVDT、RVDD、MPA增大,三尖瓣下舒张血流E/A比值降低,肺动脉收缩压不同程度增高。QTVI显示COPD各组三尖瓣环舒张早期峰值速度（Em）降低、舒张晚期峰值速度（Am）增高,等容收缩时间和等容舒张时间延长,射血时间缩短,MPI指数升高,且MPI与FEV1/pre%存在相关性（r=-0.74,P〈0.01）。结论 QTVI技术可以定量检测不同程度COPD患者右心舒张功能,并提供诊断信息。

Usefulness of quantitative tissue velocity imaging in evaluating right Ventricular diastolic function in patients with chronic obstructive pulmonary diseases

Objective To investigate the quantitative tissue velocity imaging（QTVI） for evaluating the right ventricular diastolic function in patients with chronic obstructive pulmonary disease（COPD）.Methods Thirty-nine patients of COPD（in remission） were divided into mild（group I）,moderate（group II） and severe（group III） groups with 13 cases for each group according to FEV1/FVC and FEV1/pre%,and 20 cases of normal control were enrolled in the study.All cases were examined with conventional echocardiography and QTVI technology.The parameters of right ventricular free wall diastolic thickness（RVDT）,right ventricular diastolic diameter（RVDD）,inner diameter of main pulmonary artery（MPA）,mitral E/A ratio,systolic pulmonary artery pressure（SPAP）,early diastolic peak velocity（Em）,late diastolic peak velocity（Am） and its average were measured and myocardial performance index（MPI） was calculated according to the formula.All parameters were compared with those of normal control.Results In patients with COPD,the values of RVDT,RVDD,and MPA increased,mitral E/A ratio decreased and SPAP increased in different degree on conventional echocardiography.On QTVI,the value of Em decreased,Am increased,isovolumetric contraction time and isovolumic relaxation time extended,ejection time shortened,and MPI increased and correlated with FEV1/pre%（r =-0.74,P 0.01） in patients with COPD.Conclusions QTVI technology may measure right ventricular diastolic function quantitatively in patients with COPD and provide diagnostic information.