QTVI技术评价二尖瓣机械瓣置换术后左心功能的临床研究

目的探讨定量组织速度成像（QTVI）技术评价二尖瓣置换术（MVR）术后患者中远期左室整体、局部功能的临床价值。方法对2007年10月～2010年10月MVR的45例患者的超声心动图结果进行回顾性分析。结果 1）与正常组比较,MVR组六个壁二尖瓣环Sa和Ea均明显减低,等容舒张时间（IVRT）延长;组内比较：房颤组Sa、Ea低于窦律组,而IVRT均较窦律组延长。2）与正常组比较,MVR组各心肌节段Sm和Em均明显减低。3）二尖瓣环Sa＇与LVEF呈正相关;二尖瓣环Ea＇和IVRT＇呈负相关。结论 MVR术后患者中远期亦存在左室整体舒张功能减低,影响左室充盈;MVR术后患者中远期局部心肌普遍存在不同程度的纵向收缩和舒张功能减低;房颤对左室整体收缩功能影响较为明显;QTVI技术为准确评价该类患者的心功能提供了敏感、有效的方法,可用于左心功能监测和疗效观察。

Analysis of left ventricle function in patients with mitral valve replacement with mechanical valvular by quantitative tissue velocity imaging

Objective To analyze the overall and local function of left ventricular（LV） function of patients with mitral valve replacement（MVR） in the late by quantitative tissue velocity imaging（QTVI）. Methods Retrospective analysis was performed for echocardiogaraphy in 45 patients with MVR from 2007,10 to 2010,10.Results 1）Compared with normal group,the Sa and Ea of six mitral annular sites were obvious lower threshold,and for the time extended in IVRT;compared in groups,the Sa and Ea in atrial fibrillation were lower than normal beat and the IVRT was opposite.2）Compared with normal group,Sm and Em of six sites in the heart in MVR were significantly reduced.3）Sa＇of mitral annular was related to LVEF and Ea＇of mitral annular was opposite to LVEF.Conclusions Left ventricular diastolic function of the patients with MVR also reduced in the late,which influenced the full of LV;different degree of vertical systolic and diastolic function reduced generally in local myocardium;arterial fibrillation had more noticeable impact in left vertical systolic function;QTVI technology provides a sensitive and effective method for assessment the heart function,which can be used for the monitoring and observation of left ventricular function.