实时双多普勒成像技术测量Tei指数在高血压患者左室功能评估中的价值

Value of Tei Index Measured by Dual Doppler Modality in Cardiac Function Estimation in Patients with Hypertension

Tei指数是综合评价心脏舒缩功能的超声指标,但传统计算Tei指数所需的a、b值通常在不同心动周期测量,影响了Tei指数测量的准确性,限制了其在心律失常患者中的应用。实时双多普勒(Dual Doppler)成像技术,可以允许同时测量两个不同位置的多普勒频谱,从而实现在同一心动周期同步测量Tei指数中的a、b值。本研究探讨了双频谱多普勒模式下同步测量Tei指数在评价高血压患者心脏收缩和舒张功能中的价值。纳入高血压患者140例,根据测量的左室射血分数(EF)值和舒张功能指标,将其分为心功能正常组、单纯舒张功能不全组和心功能不全组。采用双多普勒成像技术在同一个心动周期测量出a、b值,计算出同步Tei指数。结果发现,心功不全者Tei指数较无心功不全表现者明显升高,Tei指数与NYHA心功分级存在明显的线性关系,诊断心功不全时重复性、敏感性和特异性均高,且能应用于心律失常患者。

Tei-Index is a useful echocardiographic parameter for evaluating global cardiac function. Conventionally,a value and b value,which the calculation of Tei index is based on,are measured in different cardiac cycle. Therefore,accuracy of Tei index is damaged by cycle dependent variation,especially in patients with arrhythmia. The newly established Dual Doppler modality allows a synchronous measurement of both a value and b value. This study was aimed to explore the value of Tei index measured by Dual Doppler in cardiac function estimation in patients with hypertension. One hundred and forty patients with hypertension were recuited and divided into three groups according to cardiac function. The a value and b value were generated from the transmitral and transaortic flow spectrum of the same cardiac cyle by Dual Doppler modality.The results showed that Tei index was significantly higher in the cardiac dysfunction group than in the control group. There was a high correlation between Tei index and NYHA cardiac performance.Tei index measured by Dual Doppler modality is a highly reproducible parameter with high sensitivity and specificity for cardiac function estimation,even for patients with arrthymia.