目的:应用组织多普勒成像(TDI)技术研究节段性早期松弛现象(segmental early relaxation phenomenon,SERP)。方法:103例冠心病患者和50例健康志愿者,根据舒张早期心肌TDI速度曲线将左室各节段分为SERP、收缩期后缩短(PSS)和正常3种舒张...目的:应用组织多普勒成像(TDI)技术研究节段性早期松弛现象(segmental early relaxation phenomenon,SERP)。方法:103例冠心病患者和50例健康志愿者,根据舒张早期心肌TDI速度曲线将左室各节段分为SERP、收缩期后缩短(PSS)和正常3种舒张方式,分析舒张方式与冠脉狭窄之间的关系。结果:SERP和PSS易出现于冠脉狭窄的节段(OR=4.39和5.59,均P<0.01);但对每一个患者而言,SERP更易出现于冠脉相对狭窄程度最轻的节段(OR=12.53,P<0.01),而PSS不易出现于冠脉相对狭窄程度最轻和中等的节段(OR=0.33和0.41,均P<0.01)。结论:在冠心病患者中舒张早期心肌峰值速度可出现于等容舒张期,这种现象易出现于缺血程度相对较轻的节段。展开更多
Background Coronary slow flow phenomenon （CSFP） is an important, angiographic clinical entity but is lacking non-invasive detecting techniques. This study aimed to elucidate the value of transthoracic Doppler echoca...Background Coronary slow flow phenomenon （CSFP） is an important, angiographic clinical entity but is lacking non-invasive detecting techniques. This study aimed to elucidate the value of transthoracic Doppler echocardiography （TTDE） in the diagnosis and monitoring of coronary slow flow in left anterior descending （LAD） coronary artery.Methods We consecutively enrolled 27 patients with CSFP in LAD detected by coronary arteriography from August 2009 to April 2010. Thirty-eight patients with angiographically normal coronary flow served as control. Corrected thrombolysis in myocardial infarction （TIMI） frame count （CTFC） was used to document coronary flow velocities. All subjects underwent TTDE within 24 hours after coronary angiography. LAD flow was detected and the coronary diastolic peak velocities （DPV） and diastolic mean velocities （DMV） were calculated.Results Sixty of 65 （92.3%） subjects successfully underwent TTDE. Baseline clinical characteristics were similar between the two groups. Coronary DPV and DMV of LAD were significantly lower in the CSFP group than in the control group （（0.228±0.029） m/s vs. （0.302±0.065） m/s, P=0.000; （0.176±0.028） m/s vs. （0.226±0.052） m/s, P=0.000,respectively）. There was a high inverse correlation between CTFC and coronary DPV and DMV （r=-0.727, P=0.000;r=-0.671, P=0.000, respectively）. Receiver operating characteristic （ROC） curve showed that the area under the curve （AUC） was less than one half for coronary DPV （AUC=0.104） and DMV （AUC=0.204）, respectively.Conclusions In patients with CSFP, there is a high inverse correlation between CTFC and coronary diastolic flow velocities in the LAD coronary artery, as measured by TTDE. The value of TTDE in the monitoring and evaluation of coronary flow in patients with CSFP deserves further investigation.展开更多
文摘目的:应用组织多普勒成像(TDI)技术研究节段性早期松弛现象(segmental early relaxation phenomenon,SERP)。方法:103例冠心病患者和50例健康志愿者,根据舒张早期心肌TDI速度曲线将左室各节段分为SERP、收缩期后缩短(PSS)和正常3种舒张方式,分析舒张方式与冠脉狭窄之间的关系。结果:SERP和PSS易出现于冠脉狭窄的节段(OR=4.39和5.59,均P<0.01);但对每一个患者而言,SERP更易出现于冠脉相对狭窄程度最轻的节段(OR=12.53,P<0.01),而PSS不易出现于冠脉相对狭窄程度最轻和中等的节段(OR=0.33和0.41,均P<0.01)。结论:在冠心病患者中舒张早期心肌峰值速度可出现于等容舒张期,这种现象易出现于缺血程度相对较轻的节段。
基金This study was supported by grants from National Natural Science Foundation of China （No. 81070166） and Scientific Research Common Program of Beijing Municipal Commission of Education （No. KM201010025020）.Acknowledgement： We are grateful to all staff members of the Department of Cardiology and Catheterization Laboratory, Beijing Anzhen Hospital, Capital Medical University.
文摘Background Coronary slow flow phenomenon （CSFP） is an important, angiographic clinical entity but is lacking non-invasive detecting techniques. This study aimed to elucidate the value of transthoracic Doppler echocardiography （TTDE） in the diagnosis and monitoring of coronary slow flow in left anterior descending （LAD） coronary artery.Methods We consecutively enrolled 27 patients with CSFP in LAD detected by coronary arteriography from August 2009 to April 2010. Thirty-eight patients with angiographically normal coronary flow served as control. Corrected thrombolysis in myocardial infarction （TIMI） frame count （CTFC） was used to document coronary flow velocities. All subjects underwent TTDE within 24 hours after coronary angiography. LAD flow was detected and the coronary diastolic peak velocities （DPV） and diastolic mean velocities （DMV） were calculated.Results Sixty of 65 （92.3%） subjects successfully underwent TTDE. Baseline clinical characteristics were similar between the two groups. Coronary DPV and DMV of LAD were significantly lower in the CSFP group than in the control group （（0.228±0.029） m/s vs. （0.302±0.065） m/s, P=0.000; （0.176±0.028） m/s vs. （0.226±0.052） m/s, P=0.000,respectively）. There was a high inverse correlation between CTFC and coronary DPV and DMV （r=-0.727, P=0.000;r=-0.671, P=0.000, respectively）. Receiver operating characteristic （ROC） curve showed that the area under the curve （AUC） was less than one half for coronary DPV （AUC=0.104） and DMV （AUC=0.204）, respectively.Conclusions In patients with CSFP, there is a high inverse correlation between CTFC and coronary diastolic flow velocities in the LAD coronary artery, as measured by TTDE. The value of TTDE in the monitoring and evaluation of coronary flow in patients with CSFP deserves further investigation.
