超声心动图对扩张型心肌病患者左室功能的测定

Role of echocardiography in assessing left ventricular function of patients with dilated cardiomyopathy

目的:观察频谱超声心动图测量扩张型心肌病(DCM)患者左室功能的作用以及二尖瓣口血流指标对评价DCM患者左室舒张功能中的价值。方法:用超声心动图对30例二尖瓣返流较轻的DCM患者、30例二尖瓣返流严重的DCM患者和30例正常人的左室收缩功能和舒张期二尖瓣口血流指标结果分别进行对比分析。结果:同对照组比较,(1)DCM患者左室短轴缩短率(FS)和射血分数(EF)显著降低(P<0.05或P<0.0001);(2)二尖瓣返流较轻的DCM组反映左室舒张功能的二尖瓣血流频谱早期充盈峰速度(VE)、VE/VA显著降低,晚期充盈峰速度(VA)显著增加(P<0.0001);(3)二尖瓣返流严重的DCM患者上述参数无明显差异(P>0.05),表现为“正常”。结论:超声心动图能准确反映DCM患者的左室收缩功能,二尖瓣口血流指标对于二尖瓣返流轻微的DCM患者的左室舒张功能评价有一定的参考价值,而对二尖瓣返流严重DCM患者的左室舒张功能评价有待进一步探讨。

Objective: To deteimine the role of echocardiography in assessing left ventricular function and the effect of mitral blood flow velocity det :cted by Doppler ultrasonic cardiograph in assessing diastolic function of patients with dilated cardiomyopathy (DCM). Methods: The mitral blood flow velocity detected by echocardiography in three groups: DCM patients with mild mitral reflow (DCM-mild-MR, n = 30), DCM patients with serious mitral reflow (DCM-serious-MR. n = 30) and normal persons (control, n = 30). Results: Compared with control group, (1) The FS and EF of both DCM groups decreased significantly (P<0. 05, P<0. 0001, respectively); (2) The peak E velocity and E/A ratio decreased, the peak A velocity increased in DCM-mild-MR group, but there was no difference between DCM-serious-MR group and c jntrol group. Conclusion: Echocardiography can exactly evaluate systolic function of left ventricular in DCM patients. The parameters of mitral blood flow velocity are valuable in estimating the diastolic function of left ventricular for patients with DCM-mild-MR, but for patients with DCM-serious-MR this methods is disputable.