多普勒组织成像技术分析冠心病患者多巴酚丁胺超声负荷试验中缺血心肌运动的变化

Quantitatively application of Doppler tissue imaging in coronary artery disease during dobutamine infusion

目的 探讨多普勒组织成像技术 (DTI)定量分析多巴酚丁胺超声负荷试验 (DSE)过程中缺血心肌室壁运动的特征。方法 分别对 14例正常人和 2 0例冠心病患者采用标准的DSE方案 (0～ 40 μg·kg-1·min-1) ,使用DTI技术于静息状态、小剂量 (10 μg·kg-1·min-1)及峰值剂量 (4 0 μg·kg-1·min-1)负荷时观察心肌运动速度的变化 ,记录各室壁节段收缩期的峰值速度、峰值速度运动时间 ,综合计算平均收缩期室壁运动峰值速度和平均峰值速度运动时间。结果 随着多巴酚丁胺药物剂量的增加 ,正常组平均峰值速度均逐渐增加 ,平均峰值速度运动时间逐渐缩短 ;冠心病组平均峰值速度小剂量负荷时增加 ,大剂量时则下降 ,平均峰值速度运动时间呈逐渐缩短趋势 ,两组间各指标相比差异有显著性意义 (P <0 .0 0 1)。结论 DTI技术与DSE结合可定量评价缺血心肌室壁运动异常 。

Objective To quantitatively define the ischemic myocardium response to dobutamine stress echocardiography (DSE) in coronary artery disease (CAD) patients by Doppler tissue imaging (DTI).Methods Standard DSE protocol was performed in 14 healthy persons and 20 CAD patients.From DTI spectrum,peak systolic velocity (Vs),time to peak systolic velocity (Ts),average peak systolic velocity (V),average time to peak systolic velocity (T) were measured in each segment at baseline,10 μg·kg -1 ·min -1 and 40 μg·kg -1 ·min -1 during dobutamine infusion.Results V in control group increased accompanied with the dose of dobutamine,V in the segments of ischemic myocardium in CAD patients increased at 10 μg·kg -1 ·min -1 ,but decreased at 40 μg·kg -1 ·min -1 compared with 10 μg·kg -1 ·min -1 ,T in both control and CAD group decreased accompanied with the dose of dobutamine,but there were significant differences between the two groups(P< 0.001 ).Conclusions DTI DSE can quantificatively detect the changes of wall motion of ischemic myocardium,and it′s promised to detect ischemic myocardium noninvasivly.