组织二尖瓣环位移评价冠状动脉慢血流患者左心房功能

Assessment of left atrial function using tissue motion annual displacement of mitral valve in patients with coronary slow flow

目的探讨组织二尖瓣环位移(TMAD)评价冠状动脉慢血流(CSF)患者左心房功能的应用价值。方法44例CSF患者(CSF组)和42例无CSF患者(对照组)行常规超声心动图检查,采用Simpson法计算左心房射血分数(LAEF)、被动射血分数(LAPEF)和主动射血分数(LAAEF),采用TMAD检测二尖瓣环左心房充盈期位移、被动排空期位移及心房收缩期位移(TMAD_D、TMAD_P及TMAD_S)。结果与对照组比较,CSF组LAEF和LAAEF降低,且TMAD_D和TAMD_S均降低(P均<0.01)。CSF组TMAD_D和TAMD_S均与冠状动脉平均血流帧数(TFC)呈负相关(r=-0.31,-0.36,P均<0.01)。结论CSF患者左心房储器及泵功能降低,且冠状动脉血流速度越慢,功能降低越显著。TMAD可快速准确评价左心房功能,为临床治疗及预后评估提供重要依据。

Objective To explore the value of tissue motion annual displacement of the mitral valve(TMAD)for assessment of left atrial function in patients with coronary slow flow(CSF).Methods Routine echocardiography was performed in 44 CSF patients(CSF group)and 42 patients without CSF(control group),and Left atrial ejection fraction(LAEF),left atrial passive ejection fraction(LAPEF)and active ejection fraction(LAAEF)were calculated with Simpson method.Then left atrial filling period displacement(TMAD_D),passive emptying period displacement(TMAD_P)and active emptying period displacement(TAMD_S)were assessed using TMAD.Results Compared with control group,LAEF and LAAEF decreased,so did TMAD_D and TAMD_S in CSF group(all P<0.01).TMAD_D and TAMD_S were negatively correlated with mean thrombolysis in myocardial infarction frame count(TFC)of coronary artery in CSF group(r=-0.31,-0.36,both P<0.01).Conclusion In CSF patients,left atrial reservoir and pump function were damaged,which become worse with the decreasing velocity of coronary flow.TMAD is reliable and feasible for evaluating left atrial function in patients with CSF,therefore providing important evidences for clinical treatment and prognosis.