M型彩色多普勒超声评价左心室舒张功能的临床研究

Clinical study of left ventricular diastolic function in patients with heart disease by M-mode color Doppler echocardiography

目的 探讨彩色M型彩色多普勒超声评价左心室舒张功能的价值及准确性。方法 利用多普勒超声对 40例正常人和门控心血池造影后 3h内的 40例心脏疾病患者左心室舒张早期血流推进速度 (Vp)及二尖瓣环舒张早期运动速度 (E)进行测量 ;其中心肌梗死 2 2例 ,扩张性心肌病 10例 ,心肌炎 8例 ,均经核素检查存在舒张功能障碍。结果 ①心脏疾病患者Vp测值均较正常人低 ( P <0 .0 1) ,其中 ,12例患者二尖瓣血流频谱E/A≥ 1(假性正常组 ) ,Vp测值较正常人亦明显降低。②心脏疾病组Vp值与门控心血池造影舒张功能指标峰充盈率 (PFR)及二尖瓣环舒张早期运动速度E相关分析 ,发现与二者呈明显相关 ( r =0 .83 ,0 .80 ,P <0 .0 1)。结论 M型彩色多普勒测定Vp可准确评价左室舒张功能变化 ,且对二尖瓣血流频谱的假性正常化可进行鉴别。

Objective To evaluate the value and accuracy of M-mode color Doppler echocardiography for detecting left ventricular diastolic function in patients with cardiac disease. Methods The rate of left ventricular filling flow propagation (Vp) and the early -diastolic peak velocity of the mitral annulus(E) was measured in normal subjects(n=40)and in patients with cardiac disease (n=40). All the patients had abnormal left ventricular diastolic function confirmed by isotope-angiography test. Results ① The Vp was significantly lowered in patients with cardiac disease than in normal subjects(P< 0.01).Furthermore, the Vp was significantly reduced in 12 patients with E/A≥1(pseudonormalized transmitral flow pattern); ②In 40 patients, the correlation between the Vp and PFR obtained by isotope-angiography test, and the correlation between Vp and E were good(r= 0.83, 0.80 respectively,P< 0.01).Conclusions The Vp may provide an accurate method for evaluating left ventricular diastolic function and can identify the pseudonormalization of E/A.