组织多普勒显像技术检测缺血心肌的局部舒张功能

Non-invasive detection of regional distolic function in ischemic myocardium with tissue Doppler imaging

目的 :评价组织多普勒显像 (TDI)技术检测缺血心肌局部舒张功能的价值。方法 :应用超声心动图分别记录心肌缺血组 (2 8例 )和对照组 (30例 )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节段心肌 TDI。结果 :两组间左室射血分数相近 (6 2 %± 9% vs 6 6 %± 8% ,P>0 .0 5 )。心肌缺血组与对照组比较 ,TMF舒张早期减速度时间 (2 82± 17m s vs 2 0 1± 11m s,P<0 .0 5 )和等容舒张时间 (92± 18ms vs 6 1± 10 m s,P<0 .0 1)延长 ;E/A比值增加 (0 .6 7± 0 .2 vs 1.6± 0 .5 ,P<0 .0 1)。对照组 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 .0 5 ) ,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。结论 :TDI可无创检测左室局部舒张功能。

AIM: To assess the regional diastolic function of myocaardial ischemia with tissue Doppler imaging(TDI). METHODS:30 cases control subjects (Con)and 28 cases of patients with ischemic heart diseases(IHD)were enrolled. Global and reginal isovalumic relaxation 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 pulsed Doppler echocardiography and TDI respectively. RESULTS:There were no difference in LVEF between IHD and Con-groups (62%±9% vs 66%±8%, P>0.05). Compared with Con, DCTm and IRTm were prolonged (282±17 ms vs 201±11 ms,92±18 ms vs 61±10 ms, P<0.01, respectively) in IHD-group. The Em of basal and middle level of left ventricle were higher than apical level in Con-group; The slower Em, longer IRTm and DCTm were found in ischemic segments. CONCLUSION:TDI can non-invasive evaluate the regional diastolic function of ischemic myocardium. It is a valid and senssitive method for detecting of cardiac diastolic function of coronary artery disease.