摘要
目的应用经胸实时三维超声(RT 3D-TTE)结合小剂量多巴酚丁胺负荷试验,分析缺血性功能性二尖瓣返流(FMR)左室各段心肌收缩应变及局部心腔容量变化特点及二者间相关性,探讨影响缺血性FMR血流力学的因素,为临床疗效观察及预后判断提供信息。方法小剂量多巴酚丁胺使用前后,采用RT 3D-TTE及二维应变率技术(TMQ)分析缺血性FMR患者局部心腔容量性及心肌应变率变化特点。结果使用小剂量多巴酚丁胺后,左室各游离壁基、中段节段性容积(SVr)和节段容积/左室整体容积比值(rg SVratio)及应变率(Ssr)有所增加(P<0.05);上述各壁基、中段rg SVratio均值(rg SVratio-aver)分别与Ssr均值(Ssr-aver)相关(P<0.001);上述各壁基、中段rg SVratio均值在负荷前后变化值(Δrg SVratio-aver)分别和Ssr均值变化值(ΔSsr-aver)相关,下壁、下侧壁Δrg SVratio-aver与ΔSsr-aver两者间的相关系数较高(r=0.91、0.85,P<0.001)。结论局部心肌收缩能力的增加可促进对应局部心腔在心动周期内的心排量,对缺血性FMR程度的改善有促进作用。
Objective To investigate the characteristics of systolic strain and regional volume changes in leftventricular segments of patients with ischemic functional mitral regurgitation（ FMR） and the correlation between the two variables by using real-time three-dimensional echocardiography（ RT 3 D-TTE） regional volume analysis combined with low-dose dobutamine,to investigate the factors influencing ischemic FMR hemodynamics and provide information for clinical efficacy and prognosis. Methods RT 3 D-TTE and two dimensional strain rate technique（ TMQ） was used to study the regional volumetric changes and regional wall systolic motion characters during the rest condition and the small-dose dobutamine infusion. Results Compared with the resting,segmental volume（ SVr） and segmental volume/left ventricular volume ratio（ rg SVratio） and strain rate（ Ssr） on the basal-and mid-segments of anterior,lateral,inferior and posterior walls were increased after dobutamine infusion（ P〈0.05）. The mean rg SVratio（ rg SVratio-aver） of each wall basal-and mid-segments was related to Ssr mean（ Ssr-aver） respectively（ P〈0. 001）. The mean rg SVratio values of each wall basal-and mid-segments are related to the change rate of Ssr mean（ rg SVratio-aver Ssr-aver） before and after load respectively. The correlation coefficients between the lower wall and the inferior wall Delta rg SVratio-aver and delta Ssr-aver are higher（ r = 0. 91,0. 85,P〈0. 001）. Conclusion The increase of regional myocardial contractility can promote the cardiac output of the corresponding local heart cavity during the cardiac cycle,and can promote the improvement of the ischemic FMR degree.
出处
《安徽医科大学学报》
CAS
北大核心
2018年第5期755-759,共5页
Acta Universitatis Medicinalis Anhui
基金
新疆维吾尔自治区自然科学基金面上项目(编号:2015211C147)
新疆维吾尔自治区乌鲁木齐市科学技术计划项目(编号:Y141310030)
关键词
缺血性二尖瓣返流
局部容量变化
三维超声
小剂量多巴酚丁胺负荷
ischemic mitral regurgitation
regional volume changing
three -dimensional echocardiography
small-dose dobutanfine
