组织多普勒评价左室心肌梗死室壁瘤形成后整体舒张功能变化的应用研究

目的探讨和应用组织多普勒成像技术（TDI）和脉冲多普勒技术（PD），评价心肌梗死室壁瘤形成，左室重构后左室舒张功能变化。方法经多种辅助检查明确的陈旧性心肌梗死并伴心尖部室壁瘤患者30例，并设立20例正常成人对照组。分别测量二尖瓣侧壁瓣环和二尖瓣室间隔瓣环运动情况，并记录二尖瓣血流频谱，分析比较二尖瓣环舒张早期峰值速度（Ve）、舒张晚期峰值速度（Va）、Ve／Va。二尖瓣口舒张期血流速度E和A峰、E／A值，左室侧血流流速梯度变化情况。结果室壁瘤组Ve／Va、E／A均有倒置，两者之间存在相关性。Ve明显速度降低（0．05），Va无明显变化。室壁瘤组左室中部E血流速度较正常对照组降低（P〈0．05），差异有统计学意义。结论组织多普勒联合脉冲多普勒，是一种评价室壁瘤左室重构后舒张功能变化的可靠方法。

Assessment of left ventricular diastolic function in the patients with aneurysm by Doppler tissue imaging

Objective To evaluate the value of Doppler tissue imaging system and pulse Doppler in detecting left ventricular diastolic function in the patients with left ventricular aneurysm. Methods Twenty healthy subjects and thirty patients with aneurysm were assigned as contml group and aneurysm group respectively. The mitral annular diastolic velocity （ Ve. Va） was measured by tissue Doppler imaging （TDI） and left ventricular blood flow velocity （E. A） was determined by pulse Doppler （PD）. Results As compare to the control group. The Ve was significantly decreased in patients with left ventricular aneurysm （ P 〈 0.05 ）. There was no obvious change in Va. And E/A ratio was correlated with the ratio Ve/Va. The velocity of blood in the left ventricular was significantly decreased in aneurysm group when compared with control group （ P 〈 0.05 ）. Conclusion These results demonstrated that TDI and PD may accurately reflect the changes of left ventricular diastolic function. The TDI and PD were reliable methods to assess left ventricular diastolic function in the patients with aneurysm.