QTVI对风湿性心脏病合并慢性心房纤颤患者心功能的评价研究

Evaluation of heart function in patients with RHD with chronic atrial fibrillation by quantitative tissue velocity imaging

目的采用组织多普勒成像(Dopp ler tissue im aging,DTI)以及基于此的定量组织速度成像技术(quantitative tissueveloc ity im aging,QTVI),定量测量风湿性心脏病窦性心律及合并慢性心房纤颤患者的心脏各部分、各时相的运动速度、幅度,分析心肌舒缩功能的规律,以指导临床治疗。方法对11例风湿性心脏病窦性心律患者及14例合并慢性心房纤颤患者的心脏运动情况进行测量及分析比较。结果房颤患者心房较窦性心律患者大,左室射血分数(LVEF)、右室射血分数(RVEF)、左室短轴缩短百分率(FS)等指标无明显差异。三尖瓣收缩期下移距离、右室外侧壁中段收缩期下移距离SD、收缩期最大运动速度Sm、右室外侧壁近三尖瓣环处收缩期最大运动速度Sm等指标,房颤患者则显著小于窦性心律患者(P<0.01)。结论DTI/QTVI技术操作简单,细节表现能力优异,适宜于观测心脏运动,同时从左右心舒张、收缩功能来评价风湿性心脏病合并慢性心房纤颤患者的心功能更为全面、准确。合并房颤对右心功能,特别是右心收缩功能有一定影响。

Objective To evaluate the heart function in patients with rheumatic heart disease with chronic atrial fibrillation by quantitative tissue velocity imaging （QTVI）. Methods Fourteen patients with chronic atrial fibrillation compared with 11 normal rhythm individuals. The parameters of hearts movement were measured by QTVI. The data were analysed. Results In patients with chronic atrial fibrillation, the atriums are larger than the other （ P 〈 0.05 ）, and SD of tricuspid annular is lower （ P 〈 0.01 ）, and E velocity of tricuspid flow is higher （ P 〈 0.05 ）, parameters relative to systole in right ventricle are lower （ P 〈 0.05 ）. Conclusion DTI/QTVI is fit for observing and measuring the movement of heart. In patients with chronic atrial fibrillation, their systole function of right ventricle is lower than that of the other group.