无创性颈动脉瞬时减速度波强测定评价左心室舒张功能的研究

目的：探讨无创检测心功能的指标—颈动脉瞬时减速度波强（W2）评价左心室舒张功能的价值。方法：测量40例高血压病患者和43例健康对照者的左、右侧颈总动脉W2,组织多普勒测定二尖瓣环运动速度和血清脑利钠肽前体（N-terminal probrain natriuretic peptide,NT-proBNP）,分析W2与各参数间的相关性。结果：①高血压组W2低于对照组,以左侧明显（1126±996vs1690±1126 mmHg.m/s3,P〈0.01）;②高血压组与对照组比较：E/Em（二尖瓣舒张早期峰值速度/二尖瓣环舒张早期纵向运动峰值速度）增大（9.37±3.32vs7.39±1.83,P〈0.01）,NT-proB-NP升高（94.6±48.5vs45.2±13.8,P〈0.01）;③相关性分析：W2与E/Em负相关（r=-0.46,P〈0.05）,与NT-proBNP负相关（r=-0.21,P〈0.05）。结论：无创性评价血流动力学的新技术指标W2是反映早期左室舒张功能受损的敏感指标。

Evaluation on left ventricular function by non-invasive transient deceleration wave intensity (W2) of carotid artery

Objective： To evaluate transient deceleration wave intensity（W2） of carotid artery on left ventricular diastolic function.Methods： 40 patients with hypertension and 43 healthy volunteers were enrolled and W2 of carotid artery of the both sides were measured.The parameters of left ventricular diastolic function by traditional and tissue doppler imaging and NT-proBNP（N-terminal probrain natriuretic peptide） were measured.Results： ①W2 is not different between two sides of carotid artery.W2 in hypertension was lower than the control,especially in left side（1126±996 mmHg·m/s3 vs 1690±1126 mmHg·m/s3,P0.01）.②The correlation of W2 and else parameters were analyzed.There were notably decreasing in left ventricular diastolic function of the hypertensive group than the control,for example,the ratio of peak velocity of early filling of mitral flow to peak early diastolic motion velocity of mitral annulus（E/Em,9.37±3.32 vs 7.39±1.83,P0.01） and NT-proBNP（94.6±48.5 vs 45.2±13.8,P0.01）.③The correlation analysis showed negative relation between W2 and E/Em（r=-0.46,P0.05） and negative relation between W2 and NT-proBNP（r=0.21,P0.05）.Conclusion： New carotid W2 by non-invasive technology for hemodynamics is a deserving parameter in early evaluating left ventricular diastolic function.