定量组织速度成像测量二尖瓣环运动速度

目的　应用定量组织速度成像测量二尖瓣环运动速度评价扩张型心肌病患者左室舒张功能。方法　定量组织速度成像测量 14例正常人和 14例扩张型心肌病患者二尖瓣环 6个节段 (后间隔和侧壁、前间隔和后壁、前壁和下壁 )舒张早期峰值速度Ve、左房收缩期峰值速度Va ,计算Ve Va ;多普勒超声心动图测量二尖瓣口血流快速充盈速度E峰、左房收缩充盈速度A峰 ,计算E A值。结果　正常人和扩张型心肌病患者两组间E A无显著统计学差异 ,而扩张型心肌病组二尖瓣环平均Ve Va、平均Ve较正常组显著减低 (Ve Va :0 .89± 0 .11vs 1.76± 0 .76,P =0 .0 0 1;Ve :-4 .79± 2 .2 2vs -8.42± 2 .2 7,P<0 .0 0 0 1) ;正常组中二尖瓣环平均Ve Va与E A显著相关 (r =0 .63 ,P =0 .0 0 8) ,而扩张型心肌病组二尖瓣环平均Ve Va与E A无显著相关。结论　扩张型心肌病患者二尖瓣口血流频谱表现为假性正常化 ,定量组织速度成像测量二尖瓣环运动速度可准确评价其左室舒张功能。

Assessment of Left Ventricular Diastolic Function in Patients with Dilated Cardiomyopathy: Mitral Annulus Velocity Determined by Quantitative Tissue Velocity Imaging

Objective To assess left ventricular diastolic function in patients with dilated cardiomyopathy using mitral annulus velocity determined by quantitative tissue velocity imaging. Methods Mitral annulus velocities from posteroseptal,lateral,anteroseptal,posterior,anterior and inferior segments during early diastole (Ve),atrial contraction (Va) were measured by quantative tissue velocity imaging in 14 patients with dilated cardiomyopathy and in 14 age-matched healthy subjects,and then Ve/Va was calculated.Transmitral flow velocities during early diastole (E) and atrial contraction (A) were also measured by Doppler echocardiography and E/A ratio was calculated. Results E/A ratio showed no significant difference between patients with dilated cardiomyopathy and healthy subjects.Mean Ve/Va (0.89±0.11 vs 1.76±0.76,P=0.001) and Ve (-4.79±2.22 vs -8.42±2.27,P<0.0001) of the mitral annulus in the patients with dilated cardiomyopathy were significantly lower than in the controls.There was a significant correlation between mean Ve/Va of the mitral annulus and E/A ratio in healthy subjects (r=0.63,P=0.008),but not much correlation in patients with dilated cardiomyopathy. Conclusion Transmitral flow velocities pattern shows pseudonormal filling in patients with dilated cardiomyopathy,and the mitral annular diastolic velocity determined by quantitative tissue velocity imaging can assess accurately the left ventricular diastolic function in them.