起搏负荷超声与常规多普勒超声心动图对冠心病检出率的比较

Transesophageal Atrial Pacing Color Doppler Stress Echocardiography for Detecting Coronary Artery Disease

目的 通过食道心房起搏负荷试验 ,使用彩色多普勒超声心动图对左心室室壁运动状态及左心室舒缩功能改变进行评价 ,以提高冠心病诊断的检出率 ;方法 使用心脏程序刺激仪经食道起搏导管调整心率达次极量 ;同时使用彩色多普勒超声心动仪进行左心室室壁运动记分并记录二尖瓣口及主动脉瓣环部血流频谱 ;结果 经食道心房起搏增加心脏负荷 ,应用左心室每搏量 (SV)、主动脉瓣环部流速积分 (VTIAO)、等容舒张时间 (IVRT)、二尖瓣口流速积分(VTIMV) )、快速充盈分数 (RFI)及室壁运动记分指数 (WMSI)作为指标在冠心病诊断中可提高检出率 ,以WMSI结合其它两项左心室舒缩功能阳性指标 ,其冠心病诊断的检出率为 95 % ,假阳性率为 3% ;结论 经食道心房起搏彩色多普勒负荷超声心动图 (TPDE)在冠心病诊断中有较高的应用价值 ,因其简便、实用和安全 。

Objective The combining color Doppler echocardiography with transesophageal atrial pacing in improving the detection rate of coronary artery disease(CAD) was studied.Methods The heart rate was adjusted by pacing, then Doppler echocardiography was performed and four cross sections and two valve blood flow spectrum were recorded.Results The data of SV, VTI AO ,IVRT,VTI MV ,RFI and WMSI were obtained. By using WMSI and the other parameters, the high detection rate(95%) and low false-positive rate(3%) was acquired for diagnosis of coronary arteral disease.Conclusion Transesophageal atrial pacing color Doppler echocardiography(TPDE) is highly practical in detecting CAD. It is practical, easy and safe, and worth to spread its application in clinical practice.