组织多普勒观察冠状动脉旁路移植术后心肌功能的变化

Effect of coronary artery bypass grafting on myocardial function assessed by tissue Doppler imaging

目的评价冠状动脉旁路移植(coronary artery bypass graft,CABG)后组织多普勒(tissue Doppler imaging,TDI)所反映的心肌收缩、舒张功能的长期变化趋势。方法55例稳定型心绞痛患者于CABG术前、术后1周、1月、1年分别记录二尖瓣环运动的组织多普勒指标。其中43例为体外循环CABG,12例为非体外循环CABG。另外选择20例正常人群设为对照组。结果二尖瓣跨瓣血流频谱E/A在手术前、后无明显变化,组织多普勒显示左心室舒张功能在术后1年内显著改善[术前、术后1周、1月、1年时二尖瓣环舒张早期峰值分别为(6.7±2.6)cm/s,(7.1±2.6)cm/s,(7.7±2.1)cm/s,(8.2±2.3)cm/s,P<0.05],左心室收缩功能在手术前后无显著改变。体外循环与非体外循环CABG患者舒张功能改善情况并无区别。结论稳定型心绞痛患者的左心室舒张功能在CABG后迅速改善,并在手术后1年内逐步增强。

Objectives To evaluate the long-term changes in myocardial function after coronary artery bypass grafting (CABG) assessed by tissue Doppler imaging (TDI). Methods We investigated myocardial tissue peak velocities at the mitral annulus by pulsed wave TDI in 55 patients with stable angina before and 1 week,1 month and 1 year after CABG (43 with cardiopulmonary bypass on-pump, 12 beating heart off-pump) and 20 control subjects. Results TDI showed a marked improvement in diastolic left ventricl function after CABG. The early diastolic velocities were (6.7±2.6) cm / s, (7.1±2.6) cm / s, (7.7±2.1) cm / s and (8.2±2.3) cm / s before and 1 week, 1 month and 1 year after CABG (P<0.05),respectively. There were no difference in the transmitral velocity profiels and in peak systolic velocity between before and after surgery. There was also no difference in diastolic function change between the on-pump and the off-pump CABG cohort. Conclusions Diastolic function improved immediately after CABG in patients with stable angina and further improvement was seen 1 year after the operation.