二尖瓣环运动速度与位移评价扩张型心肌病患者左室收缩功能的研究

ASSESSMENT OF LEFT VENTRICULAR SYSTOLIC FUNCTION IN PATIENTS WITH DILATED CARDIOMYOPATHY BY MITRAL ANNULUS MOVEMENT VELOCITY AND DISPLACEMENT

目的探讨二尖瓣环收缩期峰值速度及收缩期位移评价扩张型心肌病患者左室收缩功能的价值。方法取心尖四腔心切面,在组织多普勒成像条件下,获取38例扩张型心肌病患者及32例正常人的二尖瓣前后瓣环的定量组织速度曲线及位移曲线,分别测量二尖瓣环的收缩期峰值速度(Vs)及收缩期位移(Ds),计算二尖瓣前后瓣环的平均峰值速度(MVs)及平均位移(MDs);用M型超声心动图测量二尖瓣前后瓣环下移距离(Dm)及计算平均下移距离(MDm),二维超声心动图法测量左室射血分数(LVEF),并进行对比分析。结果扩张型心肌病患者二尖瓣环的MVs、MDs、MDm较正常人明显减低。在扩张型心肌病患者中,用组织追踪法测量的MDs与用M型超声心动图测量的MDm显著相关(r=0.880,P<0.001),二尖瓣环的MDm(r=0.532,P=0.002)、MVs(r=0.395,P=0.025)及MDs(r=0.492,P=0.004)与LVEF亦分别显著相关。结论二尖瓣环运动速度及位移可定量评价扩张型心肌病患者的左室收缩功能,可作为临床评价左室收缩功能的新方法。

Objective TG probe the value of mitral annulus peak systolic flow velocity and systolic displacement in evaluating left ventricular systolic function of dilated cardiomyopathy patients. Methods In apical four - chamber view, quantitative tissue velocity curve and displacement curve of anterior and posterior mitral annulus were obtained in 38 dilated cardiomyopathy patients and 32 health adult by tissue doppler imaging, peak systolic flow velocities （Vs） and Peak systolic displacements（Ds） of mitral annulus were measured respectively, mean peak velocity（MVs） and mean displacement（MDs） of anterior and posterior mitral annulus were calculated; The systolic displacements （Dm） of anterior and posterior mitral annulus were measured and mean Dm（MDm） was calculated by M- mode echocardiography, left ventricular election fraction（LVEF） was measured by two- dimensional echocardiography, and these data were compared and analyzed. Results MVs, MDs, MDm of mitral annulus in dilated cardiomyopathy group were much lower than that in control group. There was significant correlation between MDs measured by tissue tracing method and MDm measured by M- mode echocardiography（r = 0, 880, P〈0. 001）. There was significant correlation between LVEF and MDm （r = 0. 532, P = 0. 002）, MVs （r = 0. 395, P = 0. 025）, and MDs （r = 0. 492, P = 0. 004）as well. Conclusion Dilated cardiomyopathy patient＇s left ventricular systolic function can be assessed quantitatively by mitral annulus movement velocity and displacement, it can be a new method for clinical evaluation of left ventricular systolic function.