多巴酚丁胺负荷试验结合多普勒评价无症状性心肌缺血左室节段与整体舒张功能

Left ventricle partial and global diastolic function evaluated in patients with silent myocardial ischemia by Doppler combined with dobutamine stress echocardiography

目的探讨多普勒组织成像（DTI）结合多巴酚丁胺负荷超声心动图（DSE）评价无症状性心肌缺血患者左室局部与整体舒张功能的价值。方法30例无症状性心肌缺血患者及正常人30例均行DSE，DTI在静息和负荷下于左房室瓣环、左室壁基底段、中间段取样，测量舒张功能参数：舒张早期速度（Ve），舒张晚期速度（Va），E峰减速时间（Te）。结果随着多巴酚丁胺药物剂量的增加，正常组峰值速度均逐渐增加，峰值速度运动时间逐渐缩短，大剂量时Ve/Va比值略有下降，差异无统计学意义；无症状性心肌缺血组峰值速度小剂量负荷时增加，大剂量时则下降，峰值速度运动时间呈逐渐缩短趋势，Ve／Va比值均显著降低，两组间各指标相比差异有统计学意义（P〈0．05）。结论DTI技术与DSE结合可定量评价无症状性心肌缺血患者左室局部与整体舒张功能。

Objective To evaluate left ventricle partial and global diastolic function in patients with silent myocardial ischemia （SMI） by Doppler tissue imaging （DTI） combined with dobutamine stress echocardiography （DSE）. Methods 30 cases of silent myocardial ischemia （SMI） and 30 cases of normal control underwent dobutamine stress echocardiography（DSE）. DTI was acquired at baseline and stress, and waveforrns in mitral valve closing,and the base and mid segments of left ventricle were used to measure diastolic early velocity（ Ve）, diastolic lately velocity（Va） ,and E deceleration time（Te）. Results V in control group increased accompanied with the increasing dose of dobutamine, Ve/Va decreased a little but not significantly. V in the group with silent myocardial ischemia （ SMI ） increased at 10μg·kg^-1·min ^-1, but decreased at 40μg· kg ^-1. min ^- 1 compared with 10μg· kg^-1·min^-1, T in both control and DSE group decreased at 40μg/kg accompanied with 10μg·kg^-1·min^-1, T in both control and DSE group decreased accompanied with the increasing dose of dobutamine, and there were significant differences between the groups（ P 〈 0.05）. Conclusion DTI-DSE could quantitficatively detect the partial and global diastolic function of left ventricle.