3种不同方法对高血压性心脏病左室舒张功能的初步评价

Evaluation of left ventricular diastolic function in hypertensive patients: Use of Doppler tissue imaging,mitral flow velocities and pulmonous flow velocities

目的 评价运用二尖瓣口血流频谱 (MFV)、肺静脉血流频谱 (PFV)和组织多普勒 (DTI) 3种不同方法 ,对检测高血压病 (EH)患者的左室舒张功能的临床应用价值 ,并验证DTI的优越性。方法 分别对 15例正常人与15例EH患者的MFV、PFV及室间隔、左室后壁心肌和二尖瓣瓣环DTI进行测量 ,并进行比较。结果 EH组MFV示E峰下降、A峰升高、E/A <1、EDT延长 ;PFV示S波、Ar波升高 ,D波下降 ,S/D >1;与正常组比较差异显著 (P<0 .0 1)。DTI测量室间隔、左室后壁E′波下降 ,E′/A′ <1,与正常组比较差异显著 (P <0 .0 1) ;同时二尖瓣前、后叶瓣环E′波亦下降 ,E′/A′<1,与正常组比较差异显著 (P <0 .0 1)。结论 3种方法相结合 ,可提高EH患者左室舒张功能异常诊断的可靠性。而且DTI可帮助判断因图像质量不好及由于左心功能不全而导致的假性正常化。

Objective To evaluate the performance of Doppler tissue imaging (DTI), standard mitral flow velocities (MFV) and pulmonary flow velocities (PFV) for assessing the diastolic function of left ventricle in essential hypertentive (EH) patients.?Methods 15 EH patients and 15 normal controls were examined by the three methods, with DTI describing the myocardial velocities of the interventricular septum (IVS), left ventricular post wall (LVPW) and mitral annulus.?Result In EH patients, MFV revealed decrease of E wave, increase of A wave, E/A<1 and elongation of E wave deceleration time(P< 0.01); PFV showed increased S and Ar waves, decreased D wave and S/D>1 (P<0.01); DTI revealed decrease of E′ wave and E′/A′<1 in the IVS and LVPW, as well as in the anterior and posterior mitral annuli (P<0.01).?Conclusions Comprehensive use of the 3 methods enhances the accuracy of the diagnosis of abnormal left ventricular diastolic function, and DTI helps to eliminate any false normal results due to blurring of images in MFV and PFV and the presence of left heart insufficiency.