多普勒组织成像鉴别肥厚型心肌病舒张功能假性正常

Identification of pseudonormal diastolic dysfunction in hypertrophic cardiomyopathy with Doppler tissue imaging

目的 探讨应用多普勒组织成像 (DTI)二尖瓣环舒张速度鉴别肥厚型心肌病舒张功能假性正常。方法 在正常人与肥厚型心肌病患者中应用脉冲多普勒技术分别测量二尖瓣口舒张早期峰值速率 (E)、舒张晚期峰值速率 (A) ,肺静脉收缩波 (S)、舒张波 (D)及心房收缩波 (Ar)。转换DTI速度模式 ,测量二尖瓣环各点舒张早期峰值速率 (Ea)、舒张晚期峰值速率 (Aa)并计算Ea/Aa。结果 肥厚型心肌病舒张功能假性正常患者与正常人二尖瓣E、A、E/A差异无显著性意义 (均 P >0 .0 5 ) ,肺静脉S、S/D、Ar差异有显著性意义 (均 P <0 .0 1) ,二尖瓣环Ea及Ea/Aa差异有显著性意义 (P <0 .0 1) ,Aa差异无显著性意义 (P >0 .0 5 )。

Objective To identify diastolic dysfunction of pseudonormal pattern of left ventricle in hypertrophic cardiomyopathy by Doppler tissue imaging(DPI).Methods The miral inflow and pulmonary venous flow were detected in patients with hypertrophic cardiomyopathy with pseudonormal pattern of diastolic dysfunction and normal volunteers.The transmitral peak rapid filling velocity (E),peak atrial filling velocity (A),and E/A radio were measured.The pulmonary venous peak systolic (S) and diastolic (D) flow velocities,S/D ratio,and peak reverse flow velocity due to left atrial systole (Ar) were recorded.At the same time,by activating DTI function,recordings of mitral anular velocities were made with pulsed wave DTI.The peak diastolic velocities of mitral annulus was measured during the early phase of diastole (Ea),the late phase of diastole (Aa) and Ea/Aa ratio.Results There were no differences in E,A,E/A between normal subjects and patients with hypertrophic cardiomyopathy(P> 0.05 ).Compared with control group,S,S/D,Ar of pulmonary venous flow were higher and Ea,Ea/Aa were lower(P< 0.01 ).However,Aa was similar in normal subjects and patients with hypertrophic cardiomyopathy.Conclusions Ea and Ea/Aa can identify left ventricular diastolic dysfunction of pseudonormal pattern in hypertrophic cardiomyopathy.