组织多普勒超声心动图评价冠心病患者心室舒张功能

Assessment of left and right ventricular diastolic function in patients with CAD using tissue Doppler echocardiography

目的采用组织多普勒技术观察冠心病患者心室舒张功能的改变及左室和右室舒张功能的关系。方法研究24例正常健康人和20例冠心病患者,应用多普勒超声技术测量二尖瓣口及三尖瓣口舒张期血流速度;应用组织多普勒超声技术测量二尖瓣环-左室侧壁交界处及三尖瓣环-右室侧壁交界处心肌运动频谱。测量二尖瓣及三尖瓣舒张早期血流速度(E)、舒张晚期血流速度(A)及E/A,心肌舒张早期运动速度(Em)、晚期运动速度(Am)及Em/Am,测量E/Em。结果与正常组比较,冠心病组左室舒张期二尖瓣血流速度E/A显著减小(P<0.01),三尖瓣血流E/A亦显著减小(P<0.01);组织多普勒所测左右心室Em、Am、Em/Am均减小(P<0.01),E/Em增大(P<0.01);冠心病组左室与右室间E/Em比值高度相关(r=0.83)。结论冠心病患者的左室舒张功能异常,伴有右室舒张功能的改变,右室与左室舒张功能的改变相关。应用组织多普勒和频谱多普勒联合评价心室舒张功能,纠正了频谱多普勒评价心室舒张功能出现的假正常现象。

Objective To use the tissue Doppler imagine（TDI）to observe the changes of diastolic function of left ventricle and right ventricle between the healthy and the patients with coronary heart disease（CHD） and discuss the relationships of functions between left ventricle and fight ventricle of patients with coronary heart disease. Methods The study includes 40 healthy and 20 patients with CHD. The pulsed Doppler was used to measure the maximal velocity of mitral flow E and A. Tricuspid indexes were also obtained by the method described as above. TDI system was used to obtain the best spectrum. Results CHD group： E/A of left ventricle is smaller compared to control group with significant discrepancy. The tricuspid flow is the same. CHD group： There was a excellent correlation of E/Em between left and right ventricle, with smaller Em, Am, Em/Am, lager E/Em, compared with control group which has significant discrepancy. Conclusion Changes may occur in functions of left ventricle in CHD companied with that in functins of right ventricle. They have relationship. Combination spectrum Doppler with TDI to evaluate ventricular diastolic function can correlt pseudonormalismtion.