评估冠心病左室舒张功能多普勒几项技术的对比研究

Comparative analysis of several Doppler techniques in assessing ventricular diastolic function in patients with coronary heart disease

目的 探讨二尖瓣口血流多普勒、肺静脉血流多普勒及组织多普勒成像技术评价左室舒张功能 ,并对该三种多普勒技术进行对比性研究。方法 对 166例冠心病患者的舒张功能进行检测 ,分别探测二尖瓣口血流舒张早期与心房收缩期峰值速度E A比值、肺静脉血流收缩期与舒张早期峰值速度S D比值以及二尖瓣环室间隔、侧壁、前壁、下壁四个壁舒张早期及晚期运动速率比值的平均值e a比值。结果 在冠心病患者左室舒张功能轻度不全时 (E A <1) ,二尖瓣环DTI测值e a <1的阳性率最高 ,为 10 0 % ,肺静脉血流S D >1.5比值的阳性率为 98%。在二尖瓣口血流频谱多普勒显示假性正常时 ( 2 >E A >1) ,二尖瓣环DTI测值e a <1的阳性率为 93 % ,而肺静脉血流频谱多普勒S D <1的阳性率仅为 76%。在二尖瓣口血流频谱多普勒显示限制性充盈时 (E A >2 ) ,二尖瓣环DTI测值e a <1的阳性率则为 5 8% ,而肺静脉血流频谱多普勒S D <1的阳性率为 83 %。结论 在舒张功能减退的早期 ,二尖瓣环DTI测值阳性率最高。在二尖瓣口血流频谱多普勒显示假性正常时 ,二尖瓣环DTI明显优于肺静脉血流频谱。在限制性充盈时 ,二尖瓣环e

Objective To compare the value of three Doppler techniques in assessing the diastolic function in patients with coronary heart disease.Methods 166 patients with coronary heart disease were enrolled in this study.The left ventricular diastolic function was detected by mitral inflow,pulmonary venous flow and Doppler tissue imaging(DTI).Results In early ventricular diastolic dysfunction(E/A<1=,the accuracy of e/a<1 of mitral annulus was 100% and the accuracy of S/D>1.5 of pulmonary venous flow's was 98%.When 2>E/S>1,the accuracy about e/a<1 and S/D<1 was 93% and 76%.While E/A>2,the accuracy of e/a<1 was 58% and the accuracy of S/D<1 was 83%.Conclusion In early ventricular diastolic dysfunction, DTI showed most accurate among the three Doppler imaging techniques. At the time of moderate ventricular diastolic dysfunction, DTI was more accurate than pulmonary venous flow.Otherwise in constrictive ventricular diastlic dysfunctoion, DTI was lower accurate than pulmonary venous flow.