多普勒组织成像技术定量分析PTCA术前后左心室局部与整体的收缩功能

目的 :采用脉冲波多普勒组织成像技术观察冠心病患者经皮腔内冠状动脉成形术 (PTCA)术前、后左心室壁及二尖瓣环运动 ,定量分析左心室局部与整体的收缩功能。方法 :16例健康人 (对照组 ) ,2 0例冠心病患者均行二维超声心动图 (2 - DE)及多普勒组织成像 (DTI)检查。冠心病患者均行选择性冠状动脉造影 (SCA) ,择期行 PTCA或 PTCA 支架术。采用 PW- DTI分析 PTCA术前、后左室壁及二尖瓣环 DTI指标 :收缩期峰值收缩速度 Vs、射血期时间 PEP、射血期时间 PEP与局部射血时间 ET之比 PEP/ ET及二尖瓣环 4个位点平均收缩速度值Vmva。结果 :冠心病患者与健康人比较 ,室壁运动异常节段 Vs显著降低 (P<0 .0 1) ,PEP延长 (P<0 .0 5 ) ,PEP/ET值增大 (P<0 .0 1) ;冠心病患者 PTCA术前后比较 ,室壁运动恢复节段 Vs显著增高 (P<0 .0 1) ,PEP缩短 (P<0 .0 5 )、PEP/ ET值减小 (P<0 .0 1) ,室壁运动未恢复节段 Vs增高但无统计学差异 ,PEP、PEP/ ET无明显变化 ;PTCA术后二尖瓣环平均峰值收缩速度 Vmva增高 ,且左室射血分数 EF与 Vmva呈显著正相关 (r=0 .81,P<0 .0 1)。结论 :PW- DTI可定量检测心肌运动变化情况 ,监测 PTCA术前后左室局部与整体收缩功能 ,为心脏病介入治疗疗效判断提供新的定量指标

Quantitive Analysing of Regional and Global left Ventricular Systolic Function Before and After PTCA by Doppler Tissue Imaging

Objective:To quantively analyse regional and global left ventricular systolic function before and after revascularization,pulsed wave Doppler tissue imaging(PWDTI)was used to detect wall motion of left ventricule and mitral valve annulus.Methods:2 DE and PWDTI were performed in 20 patients with CAD befor and after PTCA simple or with stents.PWDTI indexes included Vs,PEP,PEP/ET and Vmva(maximum average velocity).Results:Compared with healthy controls,group of patients with CAD had signiificantly reduced Vs( P <0 01),increased PEP( P <0 05)and significantly increased PEP/ET( P <0 01).After PTCA,patients with CAD had significantly increased Vs( P <0 01),decreased PEP( P <0 05),significantly decreased PEP/ET( P <0 01)and significantly increased Vmva( P <0 01).EF had a good liner relation to Vmva before and after PTCA( r =0 81, P <0 01).Conclusions:PWDTI can quantitively detect changes of myocardiac motion and real time quantify regional and global left ventricular systolic function before and after PTCA.It provides new quantitative indicators for estimating the effecancy on interventional therapy in heart diseases.