连续波多普勒和心导管测压评价二尖瓣反流患者左室收缩功能的对比研究

Comparative studies of continuons-wave Doppler echocardiography and cardiac catheterization in evaluating the systolic function of left ventricular in patients with mitral incompetence

目的连续波多普勒和心导管对比评价二尖瓣反流血流频谱,估测左心室dp/dtmax的准确性和可行性。方法105例二尖瓣反流患者,测量二尖瓣反流频谱加速支中的两点速度及两点时间差,以100mm/s的速度记录,用于估测左室dp/dtmax。其中40例患者进行了心导管左室造影检查,并同时记录左室dp/dtmax。结果40例患者多普勒频谱dp/dtmax与心导管dp/dtmax的相关系数为0.84(P<0.01),二者呈线性相关;105例患者频谱dp/dtmax与射血分数亦呈线性相关,相关系数为0.81(P<0.01)。41例射血分数小于50%的患者,多普勒频谱dp/dtmax为842±295mmHg/s,64例射血分数大于50%的患者,多普勒频谱dp/dtmax为1802±389mmHg/s。结论应用连续波多普勒二尖瓣反流速度频谱测量左室dp/dtmax的方法简便、实用,为判断患者的心功能状态提供了无创、准确、可重复追踪测量的方法。

Objective To evaluate the accuracy and feasibility of estimation of left ventricular dp/dtmax by continuous-wave Doppler mitral regurgitation velocity curve versus cardiac catheterization in patients with mitral incompetence. Methods One hundred and five patients with mitral incompetence were enrolled in this study. The Doppler spectrum of mitral regurgitation velocity was recorded with a speed of 100mm/s. The velocities and time of two points on the ascending slope of the spectrum were calculated directly in order to estimate left ventricular dp/dtmax. In 40 patients, left ventricular pressure and dp/dtmax were measured with cardiac catheterization. Results The correlation coefficient between Doppler dp/dtmax and catheterization dp/dtmax was 0. 84 （P〈0. 01 ）. The regression line for the correlation between values measured by the two methods was close to the line. The results also showed a linear correlation between Doppler dp/dtmax and ejection fraction in 105 patients,and the correlation coefficient was 0. 81（P〈0. 01）. The Doppler dp/dtmax of 41 patients whose ejection fraction was less then 50 % was 842± 295mmHg/s. The Doppler dp/dtmax of 64 patients whose ejection fraction exceeded 50% was 1 802±389mmHg/s. Condusion The method which measures left ventricular dp/dtmax by continuous-wave Doppler mitral regurgitation velocity spectrum is convenient and practical. It provides a noninvasive, reliable and simple method to estimate left ventricular systolic function and it has good reproducibility.