多普勒组织成像技术评价冠心病患者的左室舒张功能

Evaluation of Left ventricular diastolic function in patients with coronary heart disease using DTI

目的探讨多普勒组织成像(DTI)技术评价冠心病患者的心脏舒张功能的临床意义。方法多普勒组织成像技术测量36例冠心病患者及36例健康对照者的二尖瓣环舒张期运动频谱,并与脉冲多普勒测定的二尖瓣口血流频谱进行对比研究。结果发现DTI测定的二尖瓣环舒张期运动频谱有明显的规律性,有舒张期Ea和Aa两个波。冠心病组Ea波峰值速度显著低于对照组(P<0.01),而Aa无明显差异。正常人95%Ea波起始早于血流E波,而70%冠心病人Ea波晚于血流E波出现。结论 DTI测定舒张期二尖瓣环运动频谱简便易行,可以从另一方面反映左室舒张功能的改变,结合脉冲多普勒测定二尖瓣口血流频谱综合分析可以更加精确的无创评价左室舒张功能的变化。

Objective To evaluate the cardiac diastolic function of patients with coronary heart disease using Doppler tissue imaging （DTI）, and to study its clinical significance. Methods Thirty-three patients with coronary artery disease and 36 cases of healthy controls were examined by pulse Doppler and DTI. Diastolic mitral annular motion spec- trum and mitral valve flow spectrum were measured,and all data were compared. Results The diastolic mitral annu- lar motion spectrum measured by DTI was apparently had its own regularity, and there were two diastolic waves;Ea and Aa waves. The Ea wave peak speed of the CHD group was significantly lower than the normal group（P 〈 0.01）, and the Aa was not significantly different. 95% of the Ea wave in the normal subjects started early in the mitral flow spectrum, and 70% of the Ea wave of patients with coronary artery disease were late in the mitral flow spectrum. Conclusion DTI dias- tolic mitral annulus spectrum measurement is simple, it reflects the changes of left ventricular diastolic function. Combined pulse Doppler mitral flow spectrum analysis is accurate and is a noninvasive evaluation of the changes of left ventricular diastolic function.