组织多普勒显像对缺血心肌局部舒张功能的评价

Diagnostic effects of regional distolic function in ischemic myocardium with tissue Doppler imaging

目的组织多普勒显像（ＴＤＩ ）评价缺血心肌局部舒张功能的价值。方法超声心动图记录心肌缺血舒张期二尖瓣血流频谱（ＴＭＦ ）及左室基底部、中部和心尖部３个水平面１５节段ＴＤＩ 。结果两组间左室射血分值相近；心肌缺血（Ｉｓ）组ＴＭＦ 舒张早期减速度时间和等容舒张时间延长（Ｐ＜０．０１），Ｅ ／Ａ比值增加（Ｐ＜０．０１）；对照（Ｃｏｎ）组ＴＤＩ 示左室基底部与中部心肌舒张早期舒张速度（Ｅｍ）高于心尖部（Ｐ＜０．０５），缺血节段Ｅｍ降低，局部早期舒张减速度时间和等容舒张时间延长；Ｉｓ组异常显示率ＴＤＩ 高于ＴＭＦ （９３％：６４％，Ｐ＜０．０１）。结论ＴＤＩ 可无创检测左室局部舒张功能；缺血心肌呈舒缓异常，其异常出现率高于ＴＭＦ 。

Objective To assess the regional diastolic function of myocardial ischemia with tissue Doppler imaging,compare with c oronary artery angigraph.Method Global and reginal isovalumic relax ation time (IRT,IRTm),deceletation time of early filling(DCT,DCTm),early distolic velocity(E,Em),late distolic velocity(A,Am),E /A and mE /mA were measured by pulse d Doppler echocardiography and TDI re-spectively.Result There were not difference in LVEF between Is and Con -group Compared with Con,DCTm and IRTm were prolonged(P<0.01).The Em of basal and middle level of left ventricle were higher than apical level in Con -group;The slower Em,lo nger IRTm and DCTm were found in ischemic segments.We showed higher abnormal rate in Is-group(P<0.01)by comparison with transmitral flow.Conclution TDI can non -invasive evaluate the re gional diastolic function of ischem ic myocardium.It is a valid and sensitive method for detecting of cardiac diastolic function of coronary artery disease.