舒张早期心肌速率阶差评价左室舒张功能障碍的超声研究

目的 :探讨舒张早期心肌速率阶差 (MVGE)评价左室舒张功能的可行性。方法 :扩张型心肌病患者 (DCM)组 2 2例 ,高血压患者 (HBP)组 2 7例 ,正常对照组 2 5例均行常规二维超声心动图 (2 - DE)及脉冲多普勒超声心动图 (PW)和脉冲多普勒组织成像技术 (PW- DTI)检查。 2 - DE获得左室射血分数 (EF) ;PW获取二尖瓣口血流速率 E、 A、 E峰下降时间 (Dc T)及 E/ A;PW- DTI于左室乳头肌短轴切面获取左室后壁心内膜下、心外膜下心肌舒张早期峰值运动速率 VE endo、VE epi,并计算 MVGE。结果 :与正常组比较 ,DCM组 EF显著降低 (P<0 .0 1 ) ,Dc T显著缩短 (P<0 .0 5) ,E/ A显著增高 (P<0 .0 5) ;HBP组 EF与正常组间无差异 ,E/ A显著减低 (P<0 .0 1 ) ,Dc T显著延长 (P<0 .0 5)。与正常组比较 ,DCM组 VE endo、MVGE 显著减低 (分别为 P<0 .0 5和 P<0 .0 1 ) ;HBP组 VE endo、 MVGE亦显著减低 (分别为 P<0 .0 5和 P<0 .0 1 )。结论 :脉冲 DTI测定 MVGE 可早期、无创、准确反映心脏舒张功能障碍而不受收缩功能的影响

Ultrasonographic Study on Myocardial Velocity Gradient in Early Diastole as a Noninvasive Indicator of Left Ventricular Diastolic Dysfunction

Objective:To analyze the ultrasonogra ph ic significance of peak myocardial velocity gradient (MVG E) in early diastole as a noninvasive indicator of left ventricular (LV) diastolic function Methods:Two dimensional echocardiography(2 DE), pulsed wave Do ppler echocardiography(PW) and pulsed wave Doppler tissue imaging(PW DTI) were performed in 22 patients with dilated cardiomyopathy (DCM),27 patients with hyp ertension(HBP) and 25 healthy controls Ejection fraction(EF) and E/A were as 2 DE and PW indices and the velocity of subendocardial myocardium(V E endo ) and MVG E as PW DTI indices Results:Compared with healthy controls,patients in DCM gro up had a significant decreased EF( P <0 01),DcT( P <0 05) and increased E/A( P <0 05); patients in HBP group had no significant difference in EF bu t a significant decreased E/A( P <0 05) and increased DcT( P <0 05) Ho wever,both the two groups had a significant decreased V E endo and MVG E (DCM: P <0 05 and P <0 01,respectively; HBP: P <0 05 and P <0 01,respectively) Conclusions:Peak MVG E derived from PW DTI is an early, noninvasive and adequate indicator for LV diastolic dysfunction without the infl uence of LV systolic function