【摘要】 目的 :采用脉冲多普勒组织成像技术 (PW- DTI)在静息状态下定量分析心肌梗死后局部存活心肌舒缩功能。方法 :2 0例陈旧性心肌梗死患者分别行静息下 PW- DTI及小剂量多巴酚丁胺 (LDDSE)检查。采用 PW-DTI分析各节段收缩期峰值运动速度 (VS)、舒张早期、晚期峰值运动速度 (VE、VA) ,并计算 VE/VA 比值 ;LDDSE检查判别存活心肌与非存活心肌节段。结果 :1 60观察节段中室壁运动异常 92节段 (57.5% ) ,LDDSE此 92节段中 56节段 (60 .9% )判为存活心肌 ,36节段 (39.1 % )判为非存活心肌。与正常节段比较 ,存活心肌组与非存活心肌组 VS、 VE 均显著降低 (P<0 .0 1 ) ;存活心肌与非存活心肌比较 ,两组间 VS并无显著性差异 ,而前者 VE 显著高于后者 (P<0 .0 1 ) ,且 VE/VA 节段所占比率亦显著高于后者 (P<0 .0 1 )。结论 :与非存活心肌相比 ,存活心肌收缩功能同样受损而舒张功能受损较轻 ;PW- DTI可在静息状态下区分存活心肌与非存活心肌。更多还原

【Abstract】 Objective:The aim of this study was to analyze the difference in diastolic and systolic function between viable and non-viable myocardium assessed by pulsed-wave Doppler tissue imaging(PW-DTI) in basal conditions.Methods:The study population included 20 patients with old myocardial infarction PW-DTI were performed in the apical four and two chamber views in basal conditions, and in addition, dobutamine stress echocardiography was performed for the diagnosis of viable myocardium PW-DTI indices included peak velocity of systolic wave(V S), peak velocity of early or late diastolic wave(V E,V A ) and the ratio of V E and V A(V E/V A).Results:Among one hundred and sixty segments studied,92 segments(92/160,57 5%)had abnormal wall motion with 2-DE, as assessed by dobutamine stress echocardiography, 56 segments(56/92,50 9%) were considered viable and 36(36/92,49 1%) non-viable Compared with the normal segments, there were significant decrease in V S and V E in both viable and non-viable myocardial segments( P <0 01).There was no significant difference in V S between viable and non-viable myocardial segments, however, viable myocardial segments had a higher V E( P <0 01).and V E/V A>1 were more frequent in viable versus non-viable myocardial segments( P <0 01).Conclusions:Compared with non-viable myocardial segments, viable myocardial segments have same impaired regional systolic function but less impaired diastolic function assessed by PW-DTI PW-DTI can detect viable myocardium in basal conditions.更多还原