Tei指数评价风湿性心脏病二尖瓣狭窄患者左心室功能

目的运用脉冲型组织多普勒技术(PW-TDI)测算左心室心肌综合指数(Tei指数),评价风湿性心脏病二尖瓣狭窄(MS)患者左心室功能,并探讨其与右心室功能的关系。方法测量30例MS患者及25例健康对照者的常规超声心动图指标,在PW-TDI条件下测算左心室二尖瓣环四个位点(后间隔、侧壁、前壁、下壁)的Tei值及其均值(t-Tei)以及三尖瓣环位点(右心室游离壁)的Tei值,对各组值进行对比分析。结果(1)与正常对照组相比,MS患者左、右心室的Tei值明显增大(P<0.001);左心室二尖瓣环四个位点t、-Tei、右心室三尖瓣环位点的等容舒张时间延长(P<0.001)、射血时间缩短(P<0.01或P<0.05),前壁、下壁及t-Tei等容收缩时间延长(P<0.05);(2)相关性分析表明MS患者左、右心室的Tei指数呈正相关关系(r=0.73,P<0.001)。结论MS患者左心室在收缩功能正常时舒张功能已减退,左、右心室功能状态可能相互影响,重视改善MS患者左心室功能具有重要的临床意义。

Estimation of left ventricular function with Tei index in patients with rheumatic mitral stenosis

Objective To assess the left ventricular function in rheumatic mitral stenosis(MS) patients with Tei index derived from pulsed wave tissue Doppler imaging(PW-TDI) and to investigate the correlation with the right ventricular function.Methods Traditional two-dimensional Doppler echocardiography was performed in 30 patients with MS and 25 health volunteers.PWTDI data were measured on mitral annulus of interventricular septum,lateral,inferior,anterior wall of left ventricular,tricuspid annulus of right ventricle free wall from apical two-and four-chamberview by tissue Doppler imaging(TDI).Then Tei index was calculated for both left and right ventricular,mean left ventricular Tei index(t-Tei) was also calculated.The correlation of left ventricular Tei index with right ventricular function was evaluated.Results(1) The TDI-derived Tei index of left and right ventricular in MS group were different significantly compared with the healthy volunteers(P<0.001),the isovolumetric relaxation time(IRT) was higher and ejection time(ET) was lower at four different left ventricular sites,the mean index of left ventricular,and right ventricular free wall in patients with MS than controls.(P<0.01 or P<0.05).The isovolumetric contraction time(ICT)at anterior ,inferior of left ventricular and mean left ventricular ICT were significantly higher than controls.(P<0.05).(2) left ventricular Tei index correlated positively with right ventricular Tei index in MS patients(r=0.73,P<0.001).Conclusion The left ventricular diastolic function has decreased when the systolic function is normal in MS patients.Left and right ventricular function can influence each other,it is important to improve the left ventricular function of MS patients.