组织多普勒成像对射血分数正常的心衰患者左心功能评价

目的:探讨组织多普勒成像(TDI)技术评价射血分数正常的心衰患者左室长轴功能特点。方法:选取30名健康人(Ⅰ组)、EF>50%的心衰患者30名(Ⅱ组)和EF<50%的心衰患者30名(Ⅲ组)作为研究对象,采用TDI在二尖瓣环室间隔(ivs)、侧壁(l)、前壁(a)、后壁(p)、下壁(d)测量其Sm、DSm、IVCTm、TSm、Em、Am、IVRTm、TEm等指标。结果:Ⅰ组、Ⅱ组、Ⅲ组DSm、Sm逐渐减低,(P<0.05);而IVCTm、TSm逐渐升高(P<0.05);IVRTm、TEm在Ⅰ组、Ⅲ组、Ⅱ组逐渐升高(P<0.05);DSm及TEm在诊断EF>50%心衰患者心功能的指标中ROC曲线下面积最大,同样DSp及TEp在五个位点中ROC曲线下面积最大。结论:射血分数正常的心衰患者存在收缩减低;DSm及TEm是诊断EF>50%心衰患者心功能比较有效的指标;后壁是诊断的最佳位点。

Evaluation of Left Ventricular Function by Tissue Doppler Imaging in Patients of Heart Failure with Normal Ejection Fraction

Objective: To evaluate the variation of left ventricular function in the patients of heart failure with normal ejection fraction by Tissue doppler imaging.Methods: 30 healthy individuals(Group Ⅰ),30 patients of heart failure with EF>50%(Group Ⅱ) and 30 patients with EF<50%(Group Ⅲ) were selected as typical samples.Tissue Doppler Imaging(TDI) was used to measure the flow velocity of 5 sites in long axis of the mitral annular systolic peak velocity(Sm),systolic displacement(DSm),isovolumic contraction time(IVCTm),time to systolic velocity(TSm),early diastolic velocity(Em),peak velocity of trans-mitral flow by atrial contraction(Am),isovolumic relaxation time(IVRTm),time to diastolic velocity(TEm).Results: The parameters Sm and DSm decreased,and IVCTm,TSm increased gradually in GroupⅠ,Ⅱ and Ⅲ(P<0.05).IVRTm,TEm increased gradually in Group Ⅰ,Ⅲ and Ⅱ(P<0.05).DSm and IVRTm had the biggest area under ROC curve respectively to evaluate left ventricular function of heart-failure patients with EF>50%,DSp and IVRTp had the biggest area under ROC curve respectively in the five sites.Conclusions: The patients of heart failure with normal ejection fraction have systolic dysfunction in left ventricular long-axis.DSm and TEm are effective parameters to diagnose left ventricular function in the patients of heart failure with EF>50%.DSp and TEp are the optimal sites for assessing left ventricular function in the patients of heart failure with normal ejection fraction.