组织二尖瓣瓣环位移法测定二尖瓣瓣环位移对原发性高血压患者左室收缩功能的评价

Assessment of Mitral Annular Displacement by Tissue Mitral Annular Displacement for Evaluating Left Ventricular Systolic Function in Patients with Primary Hypertension

目的应用组织二尖瓣瓣环位移法(TMAD法)测定二尖瓣瓣环向心尖移动的距离(MAD),分析该技术对原发性高血压患者左室收缩功能评价的意义。方法选择原发性高血压患者并左室壁肥厚26例(肥厚组)、原发性高血压患者无左室壁肥厚23例(非肥厚组)、同期健康体检者32例(对照组),采用M型超声心动图法(M法)和TMAD法在心尖长轴切面、心尖二腔切面和心尖四腔切面的二尖瓣瓣环6个不同位置测定3组收缩期MAD值,3组左室射血分数(LVEF)用二维超声心动图Simpsons法测定。结果 M法和TMAD法测定的健康对照组、肥厚组和非肥厚组收缩期的MAD均值相关性均良好,r值分别为:0.725、0.763、0.805(均P<0.05),且MAD与LVEF的相关性良好,r值分别为0.751、0.817、0.783(均P<0.05)。肥厚组MAD明显小于健康对照组(P<0.05),而非肥厚组MAD与对照组比较差异无统计学意义(P>0.05)。结论 TMAD法测定MAD可作为一种简单、快速和无创性评价原发性高血压患者左室收缩功能的新方法。

Objective To evaluate the ability of tissue mitral annular displacement（TMAD） in assessment of the left ventricular systolic function in patients with primary hypertension through determination of the mitral annular displacement（MAD）.Methods Thirty-two normal subjects,26 primary hypertension patients with left ventricular wall thickness（hypertrophy group） and 23 primary hypertension patients without left ventricular wall thickness（non-hypertrophy group） were evaluated,and the systolic MAD was determined by TMAD and M-mode echocardiography in the apical four-chamber,two-chamber and long axis views.The left ventricular ejection fraction（LVEF） was determined by 2D echocardiography using Simpson＇s rule.Results In all patients,mean MAD measured by TMAD from 6 sites of the mitral annular were correlated closely with MAD determined by M-mode,and the related coefficient were 0.725,0.763 and 0.805（all P〈0.05）,respectively.The average MAD had a significant correlation with LVEF,and the related coefficient were 0.751,0.817 and 0.783（all P〈0.05）,respectively.Compared with normal subjects,MAD significantly decreased in hypertrophy group（P〈0.05）,while there was no significant difference between non-hypertrophy group and normal control（P〉0.05）.Conclusions The determination of MAD by TMAD provides a simple,rapid and non-invasive method for assessment of left ventricular systolic function.