多普勒组织成像技术评价不同阶段左室舒张功能障碍的价值

Value of Doppler tissue imaging in the evaluation of left ventricular diastolic dysfunction at different stages

目的探讨二尖瓣环前壁、下壁组织多普勒运动速度频谱在评价不同阶段左室舒张功能障碍中的意义。方法采用组织多普勒技术(Dopplertissueimaging,DTI)测定100例不同阶段左室舒张功能障碍患者及30例正常人的二尖瓣环前壁(mitralannu-lar/anteriorwall,MVA/AW)、下壁(mitralannular/inferiorwall,MVA/IW)运动速度频谱,并与其二尖瓣血流频谱(pulsivewave,PW)相比较。结果①弛张功能减阶段,PW-E/A,MVA/AW-E/A及MVA/IW-E/A均降低(P<0.01),MVA/AW-E/A与PW-E/A高于MVA/IW(100%和60%,P<0.01)。②假性正常化阶段,PW-E/A与正常比较,差异无显著意义(P>0.05),MVA/AW-E/A、MVA/IW-E/A降低,差异有显著性意义(P<0.01),且MVA/AW-E/A与PW-E/A符合率底于后者(20%和40%,P<0.01)。③限制性充盈阶段,3组E/A均高于正常差异有显著性意义(P<0.01),但MVA/IW-E/A与PW-E/A符合率明显高于MVA/AW-E/A(89%和22%)。结论多普勒组织成像技术测定二尖瓣环前壁、下壁运动频谱在评价左室舒张功能减退中具有重要价值。且在评价不同阶段左室舒张功能障碍时,二尖瓣环前壁及下壁分别具有不同意义。

AIM:To explore the significance of mitral annular (anterior and inferior) velocity profile measured with Doppler Tissue Imaging(DTI) at different stages of left ventricular diastolic dysfunction. METHODS:The mitral annular/anterior wall (MVA/AW) and mitral annular/inferior wall (MVA/IW) velocity profile was measured with DTI in 100 patients with diastolic dysfunction at different stages and 30 normal persons,which was compared with mitral inflow pulsive wave (PW) Doppler velocity. RESULTS:①In the relaxation decreased period,the PW E/A,MVA/AW E/A and MVA/IW E/A were all decreased as compared with the normal controls(P< 0.01).The coincidence ratio in MVA/AW E/A and PW E/A was higher than that in MVA/IW(100%and 60%, P< 0.01). ②There was no significant difference between the PW E/A and normal groups in pseudo normal period(P >0.05), while the MVA/AW E/A and MVA/IW E/A were significantly decreased(P< 0.01),and the coincidence ratio in MVA/AW and PW E/A was lower than that in the latter (20%and 40%, P< 0.01);③The E/A in the three groups was all higher than that in the normal control group(P< 0.01),but the coincidence ratio in MVA/IW and PW E/A was significantly higher than that in MVA/AW E/A(89%and 22%, P< 0.01). CONCLUSION:Mitral annular velocity profile detected by DTI has important significance in assessing the left ventricular diastolic dysfunction,and there are different values between mitral annular/anterior and inferior at different stages of left ventricular diastolic dysfunction.