定量组织速度显像评价高血压病患者左心室舒张功能的研究

QTVI Study on Left Ventricular Diastolic Function in Essenial Hypertisive Patients

目的研究高血压病患者左室整体舒张功能变化及定量组织速度显像(QTVI)估测的舒张功能参数与常规二尖瓣血流参数的相关关系。方法依照左室质量指数将高血压组患者分为左室肥厚组(LVH group,n=53)与非左室肥厚组(N-LVH group,n=50)。应用M型超声测量舒张期室间隔厚度(IVSd)、左室后壁厚度(LVPWd)、左室内径(LVEDD),常规脉冲多普勒测量二尖瓣舒张期E波峰速度(E)、A波峰速度(A)、计算E/A比值。利用QTVI技术测量二尖瓣环六位点舒张期早期运动速度(e)、舒张期晚期运动速度(a)、计算e/a。同时计算六位点平均速度(em、am、em/am)以及E/em,比较三组舒张功能指标的差异及各参数间的相关关系。结果高血压病LVH组及N-LVH组与正常对照组比较,多项舒张功能指标(ea、、e/a、em、am、em/am以及E/em)差异具有显著性(P<0.05),二尖瓣环舒张期运动速度与二尖瓣多普勒血流速度相关。结论高血压病无论是否存在左室肥厚均有舒张功能损害,QTVI为定量评价高血压病左室舒张功能提供了一种新方法。

Objeetive To evaluate global left ventricular diastolic function in essential hypertension and to investigate the correlations between mitral annular velocities by quantitative tissue velocity imaging （QTVI） and transmitral blood flow velocity in diastole. Methods 53 patients with uncomplicated hypertension were divided into LVH group（ n = 37） and N- LVH group（ n = 16） based on left ventricular mass index （LVMI）. Interventricular septum thickness （ IVSd ）, Left ventricular posterior wall thickness （ LVPWd ）, End diastolic diameter （ LVEDD ） were measured by M- mode echocardiography. Conventional left ventricular diastolic function parameters were acquired by pulsed Doppler. The mitral annular peak early （e） and peak late （a） diastolic velocities were determined by QTVI. The diastolic function parameters of the groups of LVH and N - LVH were compared with the normal group, and the corrections between the parameters were analysed. Results There were singificant differences in E, A ,E/A,%,%/a, and E/%, but no singificant difference was found in a,. Conclusion Left ventricular diastolic function are impaired in hypertensive patients regardless of LVH or N - LVH. QTVI provids a new method to quantitatively assess the cardiac diastolic function.