彩色多普勒超声心动图评价扩张型心肌病左心室舒张功能

目的　用彩色多普勒超声探讨扩张型心肌病患者左心室舒张功能的改变。方法　利用彩色多普勒超声心动图将 37例扩张型心肌病患者分为合并二尖瓣反流组及无二尖瓣反流组 ,观察其二尖瓣及肺静脉血流频谱并与正常人对照。结果　扩张型心肌病无二尖瓣反流组中仅有 41.2 %患者二尖瓣血流频谱 E/ A小于 1,其余均表现为 E/A大于 1,甚至 E/ A大于 2。扩张型心肌病合并二尖瓣反流组 E/ A均大于 2。而扩张型心肌病患者肺静脉血流频谱 ,与正常人组比较有明显差异 ,S峰均明显降低 ,D峰 >S峰 ,结论　扩张型心肌病在收缩功能减退同时有舒张功能异常 ,二尖瓣血流频谱可出现“假性正常化”,掩盖其左心室舒张功能的异常 ,应用肺静脉血流频谱有助于识别二尖瓣血流频谱“假性正常化”,但在评价扩张型心肌病合并二尖瓣反流患者左心室舒张功能时有其局限性

Left ventricular diastolic function in patients with dilated cardiomyopathy: Assessment by color Doppler echocardiography

Objective To investigate the changes of left ventricular diastolic function in patients with dilated cardiomyopathy (DCM) by color Doppler echocardiography. Methods 37 cases with DCM, divided into two groups, one of which mitral regurgitation was accompanied and the other one mitral regurgitation was not accompanied. Their mitral flow and pulmonary venous flow patterns were observed and compared with those of normal individuals. Results In 41.2 percent of the patients with DCM without mitral regurgitation, E/A ratio of mitral flow pattarn is less than l and In 58.8 percent of them, E/A ratio of mitral flow pattern is greater than l or 2. In all the patients with DCM accompanied with mitral regurgilation, E/A ratio of mitral flow pattern is greater than 2. Compared with normal ones, pulmonary venous flow pattern of the cases with DCM was obviously different. Their S- wave velocity evidently decreased and D- wave velocity was higher than S- wave's. Conclusion Decreasing of the DCM's systolic function is accompanied with abnormal diastolic function and psedonormalization appears in mitral flow pattern, which conceal the abnormal left ventricular diastolic function. Application of pulmonary venous flow pattern may be helpful in distinguishing the pseudonormalization in mitral flow pattern, nevertheless its limitation still exists in evaluating the left ventricular diastolic function of those patients with DCM accompanied with mitral regurgitation.