多普勒组织声像图评价正常人的室壁运动频谱特征

Assessment of Myocardial Wall Velocity Profile by Doppler Tissue Imaging in Normal Subjects

用多普勒组织声像图的ＤＴＩ－ＰＷＤ技术对４４例健康志愿者左心室壁节段运动情况进行研究，将左心室壁分为１３个节段，对每一节段室壁运动频谱进行定量分析。结果显示正常人室壁运动频谱有其规律性，于心电图Ｑ波后出现等容收缩波（ＩＶＣ）和收缩波（Ｓ）；于心电图Ｔ波后出现等容舒张波（ＩＶＲ）、早期舒张波（Ｅ）、反相波（Ｒ）和晚期舒张波（Ａ）。且左室后壁、下壁、侧壁的Ｓ波、Ｅ波、Ａ波分别大于相对应的前间隔、前壁和后间隔的波群速度。所有室壁节段其Ｓ波平均为７．３１±０．８２ｃｍ／ｓ，Ｅ波为８．７４±２．３８ｃｍ／ｓ，Ａ波为５．７５±０．８８ｃｍ／ｓ。并且有８５．４７％的室壁节段其Ｓ波速度大于６ｃｍ／ｓ，有９８．９３％的室壁节段其Ｓ波速度大于５ｃｍ／ｓ。结果表明ＤＴＩ－ＰＷＤ可作为评价室壁节段运动速度直观、准确的定量手段。

Forty four normal subjects were studied by pulsed Doppler tissue imaging for assessment of the left ventricular myocardial wall velocity profiles. We divided the left ventricular wall into 13 segments and detected myocardial wall velocity profiles in each segment. Results: Regularity of myocardial wall velocity profiles in normal subjects was found in each cardiac cycle. Specific isovolumic constrictive wave (IVC)、 systolic wave (S) during systolic period and isovolumic relaxation wave (IVR)、 early diastolic wave (E)、 reverse wave (R)、 atrial constrictive wave (A) during diastolic period were showed in sequence. The myocardial wall velocities of S wave、 E wave、 Awave in left ventricular posterior wall、 inferior wall and lateral wall were significantly higher than those in anterior septum、 anterior wall and posterior septum corelatively. The average values of S wave、E wave and A wave in total segments were 7.31 ±0.82 cm/s, 8.74±2.38 cm/s and 5.75±0.88 cm/s respectively. Velocities of S wave were more than 6 cm/s in 85.47% segments and more than 5 cm/s in 98.93% segments. Conclusion: Pulsed Doppler tissue imaging can provide us a quantitative、 direct and accurate method to assess left ventricular myocardial segment velocities.