慢性心力衰竭的左心室舒张功能检测

Study of left ventricular diastolic function in patients with chronic heart failure

目的探讨舒张性心力衰竭(心衰)与收缩性心衰的超声特点。方法选择舒张性心衰患者40例为舒张性心衰组,并选择基本情况与之匹配的收缩性心衰患者40例为收缩性心衰组。应用多普勒技术进行舒张功能的检测,进而评价2组在心房、心室容积,二尖瓣口血流舒张早期流速(E)与二尖瓣口血流舒张晚期流速(A)及其比值(E/A)和E峰减速时间,二尖瓣环舒张早期峰值速度(e)和二尖瓣环舒张晚期峰值速度(a)及其比值(e/a),左心房反流入肺静脉血流速度,P波终末电势等方面的差异。结果舒张性心衰组与收缩性心衰组比较,E/A、e/a倒置。舒张性心衰组E峰减速时间延长,左心房反流入肺静脉血流速度增宽。舒张性心衰组左心房增大,左心室舒张末径正常。P波终末电势负值增大。结论肺静脉血流频谱和二尖瓣环组织多普勒可作为二尖瓣血流频谱重要补充。

Objective To evaluate echocardiographic characteristics of the diastolic heart failure （DHF） compared with systolic heart failure（SHF）. Methods Forty cases of DHF were selected as group 1 and 40 cases of SHF with similar basic conditions as group 2. The examinations consisted of two-dimensional echocardio- graphy（2DE）, Doppler tissue imaging （DTI） and pulmonary vein Doppler measurements. The left ventricular ejection fraction（EF）, the velocities of early diastolic filling wave （E） and late fining wave（A） and the ratio of wave E to wave A（E/A） were measured by DTI at various points of mitral annulus. The deceleration time of E peak （DT）, the velocities of early diastolic peak（e） and late diastolic peak （a） of mitral annulus and their ratio（e/a） were also measured.Results Compared with SHF, E/A and e/a of the DHF were reversed. Atrial regurgitation wave of pulmonary vein widened, and the left atrium enlarged, the negative value of P terminal force-V1 （PtfV1） increased and the left ventricle was usually normal in DHF patients. Conclusions DTI and pulmonary vein Doppler could provide the methods for detecting the DHF.