二尖瓣环多普勒组织成像和M型超声检查对左室舒张功能的评价

Value of mitral annular velocity by Doppler tissue imaging and mitral annular motion of M-mode ultrasonic cardiography for assessing left ventricular diastolic function

目的:探讨二尖瓣环的多普勒组织成像(DTI)和瓣环的M型超声运动曲线评价左室舒张功能的作用。方法: 分别检测左室心肌肥厚组(20例)和正常对照组(25例)二尖瓣环的DTI运动频谱的收缩期峰值速度(Spv)、舒张 早期峰值速度(EDpv)和心房收缩期峰值速度(ASpv)及瓣环M型运动曲线的运动总振幅(Td)、舒张早期振幅 (EDd)和心房收缩期振幅(ASd),比较瓣口的多普勒血流频谱。结果:左心室肥厚组与正常组比较,EDpv明显减 小(7.5对13.8cm／s,P<0．01),EDpv／ASpv值明显减小(0．70对1．41,P<0．01),Spv／EDpv值明显增大(1．62 对0.96,P<0．01);EDd值减小(12．0对16．3mm,P<0．05),ASd值增大(10．1对7．5mm,P<0．05);正常组 中,EDpv及EDpv／ASpv随年龄的增加而减小。20例LVH中二尖瓣口血流E／A>1的有6例,其中5例DTI的EDpv／ ASpv<1。结论:二尖瓣环的DTI运动频谱和瓣环的M型超声运动曲线对评价左室的舒张功能有较大的价值。

Objective：To evaluate the value of mitral annular velocity by Doppler tissue imaging （DTI） and mitral annular motion of M-mode ultrasonic cardiography for assessing left ventricular （LV） diastolic function. Methods ： The mitral annular systolic peak velocity （Spv）, early diastolic peak velocity （EDpv） and atrial systolic peak velocity （ASpv） were measured by DTI, and the mitral annular total displacement （Td）, early diastolic displacement （EDd） and atrial systolic displacement （ASd） were measured by M-mode ultrasonic cardiography in patients with LV hypertrophy （20 cases） and in subjects without heart disease group （normal group, 25 cases）. Results： The EDpv （7.5 vs 13.8cm/s, P〈0.01）, the EDpv/ASpv （0.70 vs 1.41, P〈0.01） and EDd （12.0 vs 16.3 mm） significantly decreased; the Spv/EDpv （1.62 vs 0.96, P〈0.01） and ASd （10.1 vs 7.5 mm, P〈0.05） increased in the hypertrophy group compared with the normal group. The EDpv and EDpv/ASpv decreased with age in normal group. There was 6 patients who E/A〉l,in which 5 cases were EDpv/ASpv〈1 in 20 LVH cases. Conclusion： The results suggest that the annular velocity by DTI and the mitral annular motion of M-mode ultrasonic cardiography are useful for detecting abnormal LV diastolic function.