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目的:应用脉冲多普勒组织成像(DTI)定量分析并比较心绞痛与心肌梗死(心梗)患者二尖瓣环长轴方向上舒张运动速度和时间变化,探讨其评价左室整体舒张功能异常的价值。方法:冠心病心绞痛组16例、心梗组34例、对照组16例。记录二尖瓣环侧壁、间隔、前壁和下壁的运动频谱。测量舒张早、晚期峰值运动速度及其比值,舒张早期波开始时间、达峰时间和局部等容舒张时间,并计算4个位点的均值,分别以Em、Am、Em/Am、QEm、TEm和IVRTm表示。结果:心绞痛组和心梗组Em和Em/Am显著低于对照组(P<0.01),心梗组Em又低于心绞痛组(P<0.01);心绞痛组和心梗组QEm、TEm及IVRTm显著长于对照组(P<0.01或P<0.05),心梗组IVRTm又长于心绞痛组(P<0.01);IVRTm与Em呈显著负相关(r=-0.64,P<0.01)。结论:脉冲DTI所测Em、Em/Am、QEm、TEm及IVRTm均可反映冠心病患者左室整体舒张功能异常,Em和IVRTm尚可反映心肌缺血损害的严重程度。
OBJECTIVE: To quantitatively analyze and compare the diastolic velocity and time of diastolic mitral annulus in patients with angina pectoris and myocardial infarction (MI) by pulsed Doppler tissue imaging (DTI) and to evaluate the value of diastolic dysfunction value. Methods: 16 cases of coronary heart disease angina pectoris group, 34 cases of myocardial infarction group and 16 cases of control group. Record the motion spectrum of the mitral valve annulus, space, anterior wall, and inferior wall. The early and late peak diastolic velocity and its ratio, the diastolic early wave start time, the peak diastolic time and the local isovolumic relaxation time were measured. Mean values of 4 sites were calculated, and the mean values of Em, Am, Em / Am, QEm and TEm And IVRTm said. Results: The values of Em and Em / Am in angina pectoris group and myocardial infarction group were significantly lower than those in control group (P <0.01), while Em in myocardial infarction group was lower than that in angina pectoris group (P <0.01). QEm, TEm and IVRTm (P <0.01 or P <0.05). The IVRTm of MI group was longer than that of angina group (P <0.01). There was a significant negative correlation between IVRTm and Em (r = -0.64, P <0.01). Conclusion: Em, Am / Am, QEm, TEm and IVRTm measured by pulsed DTI can reflect the general left ventricular diastolic dysfunction in patients with coronary heart disease. Em and IVRTm still reflect the severity of myocardial ischemia.