多普勒组织成像对慢性心力衰竭左室舒缩功能的评价作用

Assessment of left ventricular systolic and diastolic function by Doppler tissue imaging in patients with chronic heart failure

目的:探讨脉冲多普勒组织成像(PW DTI)技术在评价慢性心力衰竭(CHF)左室舒缩功能方面的应 用。方法:应用PW DTI技术测量35例CHF患者和25例正常对照者二尖瓣环运动速度(MAV)并与常规超声心功 能指标进行对照分析。结果:CHF患者二尖瓣环收缩期、舒张早期和舒张晚期峰值速度(分别为Sa,Ea,Aa)及舒张 早、晚期峰值速度比值(Ea/Aa)低于正常人(P<0.01)。Sa与左室射血分数(LVEF)显著正相关(r=0.890, P<0.001)。CHF组舒张功能受损程度不同各亚组的Ea(P<0.001)、充盈假性正常和限制性充盈异常亚组的 Aa(P<0.001)及松弛功能减低和充盈假性正常亚组的Ea/Aa(P<0.001;P<0.01)低于正常组。结论:PW DTI技 术测量MAV可以较好地评价CHF左室舒缩功能。

Objective To investigate the application of pulsed-wave Doppler tissue imaging (PW-DTI) in evaluating left ventricular systolic and diastolic function in patients with chronic heart failure (CHF). Methods Mitral annular velocities (MAV) were measured by PW-DTI in 35 patients with CHF and 25 healthy subjects. Traditional indices for evaluating the global left ventricular function by conventional echocardiography were also studied as a comparison. Results Peak systolic, peak early diastolic, peak late diastolic mitral annular velocities (Sa, Ea, Aa), and Ea/Aa ratio progressively decreased in CHF patients compared with the healthy subjects (P<0.01). Sa of the mitral annulus correlated linearly with the left ventricle ejection fraction (LVEF) (r=0.890, P<0.01). Compared with the healthy subjects, Ea in all 3 subgroups of diastolic dysfunction in the CHF group significantly decreased (P<0.01).Aa in 2 subgroups (pseudonormal filling and restrictive filling) decreased (P< 0.01) and the decreased Ea/Aa was found in the delayed relaxation and pseudonormal filling subgroups compared with the healthy subjects (P<0.001). Conclusion MAV measured by PW-DTI can be used for assessing the left ventricular systolic and diastolic function in CHF patients.