正常人心肌等容收缩期多普勒组织成像特点及其临床价值

Clinical value and characteristics of myocardial Doppler tissue imaging during isovolumic systolic phase of normal people

目的探讨正常人心肌等容收缩期多普勒组织成像特点及其临床价值。方法应用多普勒组织成像（DTI）对30例正常人心肌进行检测。于标准胸骨旁左室长轴观、心尖左室长轴观、两腔观和四腔观，将取样容积分别置于左室前间隔、后壁、前壁、下壁、后间隔和侧壁的基底段和中段处内膜下心肌层，获取6个壁共16个取样点的组织多普勒图像，在每一个取样点的DTI图像上测量等容收缩期正向波、负向波的峰值速度（VIVC1，VIVC2），持续时间（TIVCI，TIVC2），速度时间积分（VTIIVC1，VTIIVC2），并计算等容收缩期正、负向波峰值速度的差值DIVC（DIVC：VIVC1-VIVC2）。结果正常人左心室六个壁等容收缩期心肌各位点DTI频谱通常呈正向为主的正负双向型坡。除后壁外（包括纵向和横向）每个壁基底段、中段的VIVC1〉VIVC2，TIVC1〉TIVC2，VTIIVC1〉VTIIVC2（P〈0．05），同一节段不同壁之间及同一壁不同节段间的VIVC1比较以及VIVC2比较差异多无统计学意义（P〉0．05）。结论正常心肌等容收缩期多普勒组织成像具有明显特点，应用其可对多种心脏疾病予以评价，因而具有重要临床意义。

Objective To detect the clinical value and characteristics of myocardial Doppler tissue imaging during isovolumic systolic phase of normal people. Methods Thirty normal subjects were examined by Doppler echocardiography. The sample volumes were separately located at left ventricular post septal wall, lateral wall, anterior wall, inferior wall, anterior septal wall and posterior wall in two levels （ basal, middle）. The isovolumic contraction peak positive and negative myocardial velocities （ VIVC1, VIVC2 ）, during times （ TIVCl, TIVC2 ）, velocity time integrals （ VTIIVC1, VTIIVC2 ） and the difference（DIVC） between VIVC1 and VIVC2 were measured. Results The results showed that VIVC1 〉 VIVC2, TIVC1 〉 TIVC2, VTIIVC1 〉 VTIIVC2 （ P 〈 0.05 ） at every segment wall besides LV posterior wall of normal subjects. There were no significant defferences of VIVC1 and VIVC2 in different walls and segments （ P 〉 0. 05）. Conclusions The normal myocardial Doppler tissue imaging during isovolumic systolic phase had special charecterics, which played an important role for a lot of cardiac diseases＇ evaluation.