摘要
目的了解二尖瓣口血流波形与二尖瓣环多普勒组织成像(DTI)波形测量结果不一致性在评价左心室舒张功能中的临床意义。方法对182例窦性心律患者行常规超声心动图检查,同步心电图记录。于心尖四腔、心尖三腔、心尖二腔切面分别测量二尖瓣环室间隔、左心室侧壁、前间隔、左心室后壁、左心室前壁及下壁6个位点的DTI舒张期波形;于心尖四腔切面测量二尖瓣口舒张期波形;计算MV-E/A、DTI-e/a-ann及E/e-ann,e-ann为6个位点的平均值。结果182例患者中,依二尖瓣口血流和6个位点二尖瓣环波形的测量结果分成4组,组Ⅰ:MV-E/A<1.0,同时6个位点DTI-e/a-ann均<1.0,共68例,MV-E/A为0.71±0.16、E/e-ann为15.91±6.78;组Ⅱ:MV-E/A<1.0,同时6个位点中有1～6个位点的DTI-e/a-ann≥1.0,共38例,MV-E/A为0.76±0.12、E/e-ann为10.37±2.63;组Ⅲ:MV-E/A≥1.0,同时6个位点的DTI-e/a-ann均≥1.0,共23例,MV-E/A为1.74±0.42、E/e-ann为9.57±2.39;组Ⅳ:MV-E/A≥1.0,同时6个位点中有1～6个位点的DTI-e/a-ann<1.0,共53例,MV-E/A为1.31±0.31、E/e-ann为13.27±9.46。组Ⅰ、Ⅱ、Ⅳ的平均年龄均大于组Ⅲ(P<0.05),组Ⅰ与组Ⅱ的平均年龄和MV-E/A基本相同(P>0.05),但组Ⅰ的平均E/e-ann明显高于组Ⅱ(P<0.05);组Ⅲ与组Ⅳ比较,两者的MV-E/A差别不大(P>0.05),但后者的年龄、E/e-ann均大于前者(P<0.05);组Ⅰ、组Ⅱ与组Ⅳ之间,组Ⅳ的平均年龄小于组Ⅰ与组Ⅱ,但组Ⅳ的E/e-ann小于组Ⅰ而大于组Ⅱ(P<0.05)。结论①MV-E/A<1.0伴有6个位点DTI-e/a-ann均<1.0提示左心室充盈压较高;②MV-E/A≥1.0,同时6个位点中有1～6个位点的DTI-e/a-ann<1.0者有左心室充盈压较高的倾向;③MV-E/A<1.0,同时6个位点中有1～6个位点的DTI-e/a-ann≥1.0或MV-E/A≥1.0或同时6个位点的DTI-e/a-ann均≥1.0者的左心室充盈压可能有较大变数;④年龄对MV-E/A和DTI-e/a-ann测值有较大影响。
Objective To explore the clinical significance of the disagreement between transmitral pulsed wave Doppler （PWD） and mitral annulus Doppler tissue imaging （DTI） in the estimation of left ventricular （LV） filling pressures. Methods One hundred and eighty-two sinus rhythm patients without arrhythmia, congenital heart disease and valvular disease underwent routine echocardiography and synchronous electrocardiogram for assessment of LV function. Early and late dias tolic velocities of LV, which were composed of e and a waves, were recorded using DTI at the mitral annulus. Six sites at the mitral annul were selected corresponding to the septal, lateral, anterior septal, posterior, inferior, and anterior walls of LV from apical 4-, 3-and 2-chamber views. Transmitral diastolic flow velocity, which was represented by E and A wave, was measured with PWD from apical 4-chamber view. Ratio of early and late diastolic transmitral valve （MV-E/A）, ratio of DTI-e/a-ann ant） ratio of E/e-ann were calculated, respectively. The mean value of e-ann from the above 6 sites was selected to describe the early diastolic velocities of mitral annular. Results According to the results of MV-E/A ratio and DTI-e/aann ratios of the 6 sites, these 182 patients were divided into 4 groups： group [ （n=68） ： MV-E/A〈1. 0, DTl-e/a-ann〈1.0 at all the 6 sites at the same time, with mean MV-E/A ratio being 0.71±0. 16 and mean E/e-ann ratio 15.91±6.78; group Ⅱ （n=38）： MV-E/A〈1. 0, DTI-e/a-ann≥1. 0 at 1--6 sites among the total sites, with mean MV-E/A ratio being 0.76±0.12 and mean E/e-ann ratio 10.37±2. 63; group Ⅲ （n=23） ： MV-E/A≥1. 0, DTI-e/a-ann≥1. 0 at all the 6 sites at the same time, with mean MV-E/A ratio being 1.74±0. 42 and mean E/e-ann ratio 9.57±2.39; group Ⅳ （n=53）： MV-E/ A≥1. 0, DTI-e/a-ann（1.0 at 1-6 sites among the total sites, with mean MV-E/A ratio being 1.31±0.31 and mean E/eann ratio 13.27±9.46. The mean ages of group Ⅰ, Ⅱ and Ⅳ were older than that of grou
出处
《中国医学影像技术》
CSCD
北大核心
2009年第10期1785-1788,共4页
Chinese Journal of Medical Imaging Technology
关键词
二尖瓣口
二尖瓣环
超声检查
多普勒
脉冲
左心室充盈压
Transmitral
Mitral annulus
Ultrasonography, Doppler, pulsed
Left ventricular filling pressures
