多普勒组织成像评价房间隔缺损并肺动脉高压患者右心室舒张功能

目的探讨多普勒组织成像(DTI)技术评价房间隔缺损(ASD)并肺动脉高压患者右心室舒张功能的临床意义.方法56例ASD并肺动脉高压患者按肺动脉高压程度分为轻、中、重3组,并选取22例健康人作为正常对照组.采用频谱多普勒技术分别测定三尖瓣口舒张早期血流峰值速度e波、舒张晚期血流峰值速度a波,并计算e/a比值.然后进入DTI条件,测定三尖瓣环舒张早期运动峰值速度E波、舒张晚期运动峰值速度A波,并计算E/A比值.结果ASD并肺动脉高压患者右心室舒张功能随肺动脉压力的升高而逐渐减低;与频谱多普勒检测三尖瓣口充盈参数法相比,DTI法在ASD并轻、中度肺动脉高压患者中,对右心室舒张功能异常检出率更高,而在重度肺动脉高压患者中两者无差别.结论DTI在早期检测ASD并肺动脉高压患者右心室舒张功能减低方面较频谱多普勒具有优越性,其不但能早期预测病情变化,且可以帮助判断病情变化程度.

Doppler tissue imaging for assessment of diastolic function of right ventricle in ASD patients with pulmonary hypertension

Objective To explore the clinical value of Doppler tissue imaging (DTI) in assessment of diastolic function of right ventricle in atrial septal defect (ASD) patients with pulmonary hypertension. Methods Overall, 56 ASD patients with pulmonary hypertension were divided into 3 groups (mild, moderate and severe groups) according to the degree of pulmonary hypertension; meanwhile 22 healthy individuals were selected as controls. Under 2-dimensional echo image of 4-chamber view, PW was applied to measure pe early diastolic tricuspid annular velocity (e) , peak late diastolic velocity of atrial contraction (a) , e/a ratio and peak velocity of tricuspid regurgitation. DTI parameters included peak early diastolic tricuspid annular velocity (E) , peak late diastolic velocity of atrial contraction (A) , E/A ratio and isovolu-mic relaxation time (IR) intervals. Results The diastolic function of right ventricle was prominently correlated with puhnonary hypertension. DTI was more effective than Doppler flow imaging in diagnosing diastolic dysfunction of right ventricle in mild and moderate puhnonary hypertension patients. However, there was no difference in diagnosing the diastolic dysfunction of right ventricle in severe puhnonary hypertension between the 2 techniques. Conclusions DTI is more effective than Doppler flow imaging in noninvasive assessment of right ventricular function in ASD patients with pulmonary hypertension.