利用心肌功能指数评价窄QRS波的扩张型心肌病患者局部舒缩功能

Assessment of Regional Systolic and Diastolic Function in Dilated Cardiomyopathy Patients with Narrow QRS Wave by Myocardial Performance Index

目的:超声评价窄QRS波的扩张型心肌病患者左室局部心肌的收缩和舒张功能.方法:超声测量21例窄QRS波的扩张型心肌病患者(DCM组)和21例正常人(control组)各二尖瓣瓣环,获得等容收缩期、射血期、等容舒张期、舒张期的持续时间(ICT、ET、IRT、DFT),计算评价左室整体和局部心肌综合指数,以及局部收缩期和舒张期心肌功能指数.结果:窄QRS波的扩张型心肌病患者患者左室各壁等容收缩时间(ICT)和等容舒张时间(IRT)明显延长,舒张充盈时间(DFT)缩短,整体和局部心肌综合指数明显增高,局部收缩期(SMPI)和舒张期心肌功能指数(DMPI)也增高.结论:扩张型心肌病时左室整体和局部心肌综合指数明显异常,提示左室局部舒缩功能普遍受损.利用组织多普勒测量整体和局部心肌综合指数可以快速、无创、敏感地评价局部心肌的功能.

Objective： To observe regional systolic and diastolic function of left ventricular myocardium in dilated cardiomyopathy patients with narrow QRS wave by quantitative tissue velocity imaging （QTVI） .Method： We study left ventricular regional myocardium of at 21 dilated cardiomyopathy patients with narrow QRS wave （DCM group） and 21 normal persons（control group）. The echocardiographic images were collected in all cases and analyzed off- line. The profiles of left ventricular myocardial velocity were investigated in mitral annulets of different walls, the durations of isovolumic contraction, ejection, isovolumic relaxation, diastolic phases （ICT, ET, IRT, DFI＇） were obtained. Total and regional left ventricular myocardial performance indexes were calculated. Furthermore, systolic and diastolic myocardial performance indexes were also measured. Results： ICT and IRT were longer and DFT were shorterin different sites of left ventricle of DCM group than those of control group. Total and regional （including regional systolic and diastolic myocardial performance index ） were significantly higher in DCM group than control group.Conclusion： Total and regional left ventricular myocardial performance indexes were apparently abnormal in dilated cardiomyopathy patients with narrow QRS wave, suggesting that dilated cardiomyopathy caused both total and regional systolic and diastolic function impaired. Tissue velocity imaging can quickly, non - invasively, sensitively assess regional myocardial function.