【摘要】 目的应用脉冲组织多普勒(Pulsed-Wave Tissue Doppler Imaging,PW-TDI)测量冠心病左室节段性心内膜回声增强部位心肌运动速度,初步探讨其与心肌缺血的联系。方法应用超声心动图及PW-TDI技术检测27例下壁基底段心内膜回声增强病例组、18例后间隔基底段心内膜回声增强病例组及20例正常对照组常规二维超声测值及二尖瓣环速度及心肌运动速度,得到等容收缩期加速度(IVA)、等容收缩期峰值流速(IVV)、收缩期峰值流速(Sa)、舒张早期峰值流速(Ea)、舒张晚期峰值流速(Aa),并进行统计学分析。结果 3组间常规二维超声测值差异无统计学意义,反应左心室功能的PWTDI参数Aa增高,Ea减低,IVA减低,与对照组相比差异有统计学意义;Sa及IVV在各组间比较差异均无统计学意义。结论 PW-TDI等容收缩期参数可早期、无创检测冠心病节段性心内膜回声增强部位的心肌收缩功能的减低,提示存在心肌缺血。更多还原

【Abstract】 Objective To assess the segment myocardial function under the endocardium of high echo-intensity by using pulse wave tissue Doppler imaging(PW-TDI) derived indices, and to evaluate the relationship between these parameters and myocardial ischemia. Methods A total of 27 patients with high echo-intensity endocardium on inferior, 18 patients with high echo-intensity endocardium on posterior septum, and 20 normal controls detected by using TW-TDI technique were enrolled in this study. Conventional two-dimensional(2 D) parameters of left heart and TDI derived systolic velocities of mitral annulus, including peak systolic velocity during ejection period(Sa), early diastolic peak velocity(Ea), late diastolic peak velocity(Aa), peak myocardial velocity during isovolumic contraction(IVV), and isovolumic myocardial acceleration(IVA) were measured and statistically analyzed. Results Conventional 2 D parameters of left heart had no statistical difference among 3 groups. The pulse tissue doppler parameters(Aa was increased, Ea and IVA were decreased) which could reflect the function of left ventricular were significanthy changed compared to that of control group. There was no significant difference of Sa and IVV among 3 groups. Conclusion Isovolumic contraction parameters of PW-TDI can be used to evaluate the myocardiol ischemia in patients with high echo-intensity endocardium early and noninvasively and can indicat myocardial ischemia.更多还原