摘要
目的了解二尖瓣环的不同位点对多普勒组织成像(DTI)测量结果及衍生指标评价左室舒张功能的影响。方法 182例接受常规超声心动图检查患者,于心尖四腔切面测量二尖瓣口舒张期血流频谱,于心尖二腔、三腔及四腔切面分别测量二尖瓣环室间隔、前间隔、左室侧壁、后壁、前壁及下壁6个位点的DTI舒张期波形,计算二尖瓣口血流舒张早期E峰和舒张晚期A峰的比值(MV-E/A)、二尖瓣环舒张早期e波和舒张晚期a波的比值(e/a-ann)及E峰和二尖瓣环e波平均值的比值(E/e-ann-mean)。接同步心电图。结果根据二尖瓣口血流波形E/A不同,将182例患者分成2组,A组76例:MV-E/A≥1.0,B组106例:MV-E/A<1.0;A组中同时有4个位点e/a≥1.0的患者多于B组,而B组二尖瓣环6个位点e/a均<1.0的患者多于A组(P<0.05);即使同一组内,任意两位点之间的E/e多有不同或差异显著,测值相近的位点在两组中均约占14.29%,其中A组中仅有后壁、下壁的E/e与E/e-ann-mean相近的位点,而B组中则没有与E/e-ann-mean相近的位点。结论临床应用E/e-ann与MV-E/A评估左心室舒张功能时,需注意二尖瓣环位点的不同对测量结果的影响,而取二尖瓣环6个位点e波的平均值,有助于减少此类指标在评价左室舒张功能中的偏差。
Objective To understand the influence of mitral annulus sites on measurements and derived indexes of Doppler tissue imaging（DTI） in evaluating diastolic function of left ventricle （ LV ）. Methods One hundred and eighty - two patients were examined by echoeardiography, and DTI diastolic wave of six sites in septum of mitral annulus, lateral, anterior, posterior, inferior, and anterior walls of LV at apical two, three and four chamber view were measured, respectively. Then the ratio of early and late diastolic transmittal valve （ MV - E/A ） , ratio of DTI e/a - ann and ratio of E/e - ann - mean were calculated, respectively. The simultaneous electrocardiogram was connected. Results According to the results of MV - E/A ratio, 182 patients were divided into two groups： 76 patients in group A, MV -E/A ≥ 1.0; 106 patients in group B, MV -E/A 〈 1.0. There were more patients with 4 or more than 4 sites＇ e/a≥ 1.0 at the mitral annuli in group A than those in group B, while the patients with 6 sites e/a 〈 1.0 in group B were more than those in group A（ P 〈 0.05 ）. Even in the same group, there was significant difference of E/e between two sites at the mitral annul/. In two groups, incidence of similar E/e ratio at the 6 sites was both of 14.29% , and there were only posterior and inferior wall with similar E/e and E/e - ann - mean in group A, while no site in group B. Conclusion More attention should be paid to the effects of mitral annulus sites on DTI measurements when E/e - ann and MV - E/A are applied for estimating the diastolic function of LV in clinic, and selection of the mean value of e - ann from 6 sites can describe the early diastolic velocity of mitral annular（ E/e - ann - mean） , and improve the efficiency of the index in evaluating LV diastolic function.
出处
《临床超声医学杂志》
2011年第1期4-8,共5页
Journal of Clinical Ultrasound in Medicine
关键词
二尖瓣环
脉冲多普勒
组织多普勒
舒张功能
左心室
Mitral annulus
Pulsed wave Doppler
Tissue Doppler
Diastolic function,left ventricle
