定量组织速度成像技术评价冠心病左心室局部心肌收缩与舒张功能的研究

Assessment of left ventricular function in patients with coronary artery disease(CAD) using quantitative tissue velocity imaging

目的探讨定量组织速度成像(QTVI)技术评价冠心病(CAD)患者左心室心肌收缩与舒张功能的价值。方法应用QTVI获取35例正常人和35例CAD患者左心室长轴方向不同室壁节段的心肌多普勒速度曲线,分析并比较收缩期峰值速度(Vs)、收缩期加速度(a)、快速充盈期和心房收缩期的速度(Ve和Va)、二尖瓣舒张期血流频谱E/A值、左心室射血分数(LVEF)、左心室质量指数(LVMI)、Vs/Ve、Va/Ve比值。结果CAD患者Vs、Ve、Va、a、Vs/Ve、LVEF均比正常人降低;CAD患者Vs的测值与临床NYHA分级有相关性(r=0.73),Ve/Va与E/A有明显相关关系(r=0.74)。结论QTVI定量提供了一种较精确的评价CAD患者左心室局部心肌收缩舒张功能变化方法。

Objective To investigate the value of quantitative tissue velocity imaging（QTVI） in assessing the left ventricular（LV） regional systolic and diastolic function in patients with coronary artery disease（CAD）.Methods 35 normal volunteers and 45 CAD patients underwent QTVI study. Off- line LV regional velocity imaging and displacememnt profiles along LV apical long- axis view were obtained synchronously. Peak velocities of LV regional muscular tissue during systole （Vs）, systolic acceleration （a）, early diastole（Ve）, LA contraction（Va）, LV ejection fraction（LVEF）, mitral valve peak flow velocity E/A ratio, left ventricular mass index（LVMI） were measured and compared between the two groups.Results Vs,Va,Ve,Vs/Ve,LVMI,a,LVEF were significant reduced in CAD patients than those in normal volunteers and LVMI, Va/Ve were higher than those in CAD patients. There was significant relationship between Vs and NYHA class. Ve/Va in interventricular septum（1VS） was correlated well with E/A （r = 0.74） in CAD patients. Conclusion QTVI offers a new method in clinical practice which has a higher sensitivity and accuracy in evaluating the LV regional aystolic and diastolic function in CAD patients.