多普勒综合射血等容期指数鉴别二尖瓣血流波形假性正常化

Utility of total ejection isovolume index in differentiating normal from pseudonormal mitral flow pattern

目的 评价综合射血等容期（ＴＥＩ） 指数在鉴别二尖瓣血流波形假性正常化中应用的价值。方法 病例包括接受左心导管检查且二尖瓣血流Ｅ／Ａ≥１．０ 的连续４３ 例患者，通过左室流入及流出道血流频谱测算ＴＥＩ指数。结果 左室舒张末期压力（ＬＶＥＤＰ） ≥２．４ ｋＰａ 的假性正常组ＴＥＩ指数明显高于ＬＶＥＤＰ小于２．４ ｋＰａ 的正常组，ＴＥＩ指数≥０．５ 诊断假性正常化的敏感度、特异度和准确度分别为１００％ 、９１ ％ 和９５％ 。结论 ＴＥＩ指数是鉴别二尖瓣血流假性正常化的一种准确实用的无创指标。

Objectives The study was performed to investigate the feasibility of TEI index to differentiate pseudonormal from normal mitral flow pattern. Methods Consecutive 33 patients who underwent cardiac catheterization and had mitral E/A≥1.0 were studied. According to whether left ventricular end-diastolic pressure(LVEDP)≥2.4 kPa( 18 mmHg) or not, the subjects were divided into normal group (n=13) and pseudonormal group (n=20). TEI index was measured from pulsed-wave Doppler LV inflow and outflow recordings as (a+b)/b, where a is the interval between cessation and onset of mitral inflow, and b is the aortic ejection time. Results TEI index was significantly higher in the pseudonormal group than that of the normal group. Taking the upper limit of normal range of TEI index (0.5) as diagnostic criterion, the sensitivity, specificity and accuracy for distinguishing normal from pseudonormal pattern was 100%, 90% and 94%, respectively. Conclusion TEI index allows simple and noninvasive differentiation of pseudonormalization of mitral flow velocity curve pattern.