急性心肌梗死后近期二尖瓣环运动速度的测定

Significant of mitral annulus velocities in evaluating left ventricular function in patients with acute myocardial infarction

目的:应用多普勒组织成像(DTI)测定二尖瓣环运动速度,定量分析急性心肌梗死(AMI)后近期患者的左室收缩和舒张功能。方法:研究对象为68例确诊首次AMI的患者和22例正常人。所有患者于发病后第3天、出院前、发病后4周、发病后12周,行常规超声心动图检查及DTI测定二尖瓣环运动速度频谱。结果:68例患者中有56例患者完成了12周的随访。随访的12周内,患者二尖瓣环收缩期运动速度(Sm)、二尖瓣环舒张早期运动速度(Em)始终低于对照组;除AMI后第3天以外,患者的二尖瓣环舒张晚期运动速度(Am)始终低于对照组、E/Em始终高于对照组。AMI后12周时的Sm、Em及Am均低于AMI后第3天水平(均P<0·05)。结论:DTI测量二尖瓣环运动速度,可作为定量检测AMI患者近期心脏功能状态的一种方法,具有一定的应用价值。AMI患者近期组织多普勒参数的变化需进一步研究。

Objective： To quantitatively analyze left ventricular systolic and diastolic function after acute myocardial infarction by mitral annulus Doppler tissue imaging. Method： Echocardiography with Mitral annulus Doppler tissue imaging was performed in 68 patients with AMI and 22 control participants. The peak velocities of mitral annulus movement in systolie（Sm） and early diastolic （Em） and late diastolic （Am） phase were obtained. Also the ratio of mitral velocity to early diastolic velocity of the mitral annulus （E/Em）. Result： There were 56 patients finished 12 weeks follow up. Compared with controls Sm and Em of AMI group were significantly lower in AMI patients at the 48～96 hours after onset （P 〈 0.05）, while Am and E/Em were no difference comparing between patient group and control group. Sm, Em, and Am of AMI patients during follow up were significantly lower than control group, while E/Em was higher than control. Sin, Em and Am of AMI patients at 3 month after onset were significantly lower than the basic value at 48～96 hours （P〈0.05）. Conclusion： Mitral annulus Doppler tissue imaging can quantitatively evaluate the left ventricular systolic and diastolic function in patients after acute myocardial infraction. Deep research should be do concern the trend of mitral annulus velocity change after AMI.