【摘要】 目的: 探讨多平面经食管超声心动图 (TEE) 测定冠状窦血流评估心肌肥厚患者冠脉血流储备(CFR) 的可行性及对心肌肥厚的诊断价值。方法: 对42 例心肌肥厚患者和10 例正常对照静脉注射潘生丁, 分别测量静息状态 (Rest) 及注射潘生丁后 (DPM) 冠状窦血流频谱收缩期、舒张期、舒张末期逆行心房波最大流速 (S、D、A) 及流速积分 (VTI-S、VTI-D、VTI-A), 以 (VTI-S+ VTI-D) - (VTI-A) 得净前向流速积分 (VTInet),再以VTInet×HR 代表冠状窦实际前向血流(CSF), 以CSFDPM/CSFREST　　计算CFR。结果: 所有患者均可记录到满意的冠状窦血流频谱, 心肌肥厚患者冠脉血流储备明显低于正常对照组 (1.85±0.53, 3.0±0.55, P< 0.001), 以2.4 作为临界值, 则检出心肌肥厚的敏感性为83.33% (35/42), 特异性为90% (9/10)。因此经食管超声心动图测定冠状窦血流评估冠脉血流储备具有很好的可行性及临床应用价值更多还原

【Abstract】 Objective:To evaluate the feasibility of coronary sinus flow velocity analysis by transesophageal Doppler echocardiography for estimation of coronary flow reserve.Methods:42 patients with left ventricular hypertrophy(LVH)and 10 control subjects were studied before and after dipyridamole administration(0 56 mg/kg body weight per 4 min).We used the formula anterograde minus retrograde flow velocity time integral times heart rate as an index of coronary sinus flow.Coronary flow reserve was calculated by dividing coronary sinus flow variables after dipyridamole administration by the respective baseline values.Results:Coronary sinus flow velocity recordings were obtained in all patients(100%).Coronary flow reserve was significantly lower in patients with LVH,compared with that in the control subjects(1 85±0 53 vs 3 0±0 55, P <0 01).Using a cutoff coronary flow reserve value of 2 4,sensitivity and specificity were,respecitvely,83 33% and 90% for LVH.Conclusion:Coronary flow reserve calculation by transesophageal coronary sinus flow velocity recordings is feasible in patients and might be useful for the noninvasive evlauation of patients with LVH.更多还原