二尖瓣环运动速度评价心肌梗死患者左心室舒张功能

Assessment of left ventricular diastolic function of patients with myocardial infarction by mitral annulus velocity

目的 :用组织多普勒超声技术测定二尖瓣环舒张期运动速度以评价心肌梗死 (MI)患者左心室舒张功能。方法 :对 6 0例正常人和进行门控血池造影 3h内的 30例MI患者的舒张期二尖瓣环运动速度进行测量 ,分别在心尖四腔切面和二腔切面上测量二尖瓣环间隔处、侧壁处、前壁处及后壁处的各位点舒张早期运动速度峰值Em、舒张晚期运动速度峰值Am ,并计算上述四位点Em/Am比值的平均值M ,同时测定二尖瓣口舒张期血流频谱E峰和A峰的E/A比值。结果 :①MI患者的M值较正常对照组明显下降 (P <0 0 5 ) ;②将 30例心肌梗死患者的M值与核素测得的左心室峰充盈率进行相关分析 ,结果明显相关 (r=0 80 ,P <0 0 1 ) ;③在 1 3例心肌梗死患者中 ,二尖瓣血流频谱表现为正常 ,而二尖瓣环运动速度频谱仍能表现出舒张功能的异常。结论 :测量二尖瓣环舒张期运动速度可以评价心肌梗死患者的左心室舒张功能 。

Aim:To evaluate left ventricular diastolic function using diastolic mitral annular velocity by Doppler tissue echocardiography.Methods:30 patients with myocardial infarction (MI) and 60 age ?and gender ?matched healthy subjects were involved.Doppler tissue M mode studies were obstained from each of 4 mitral annular sites:septal and lateral from apical 4 chamber views ,anterior and posterior from 2 chamber views.The early diastolic and late diastolic peak velocity of the mitral annulus(Em,Am respectively) were measured and the mean value of Em/Am ratio (M) from the above four sites was calculated. Results:①All the MI patients had a decreased M. ②There was a good relation between the M and the PFR obstained by radionuclide ventriculography in the MI patients. ③In 13 cases of all MI patients ,the mitral annular velocity is manifested with Em/Am<1 although the mitral flow velocity spetral showed a pseudo normal pattern.Conclusion:The diastolic mitral annular velocity can be used as a method to evaluate the LV diastolic function in MI and is more sensitive than the mitral flow velocity.