组织运动二尖瓣环位移自动追踪技术评价冠心病患者左心室功能
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南京军区医学科技创新项目(12MA032)


Evaluation of Left Ventricular Function in Patients with Coronary Heart Disease by Automated Motion Tracking of Mitral Annular Displacement
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    摘要:

    目的探讨组织运动二尖瓣环位移自动追踪技术(TMAD)评价冠心病患者左心室收缩及舒张功能。方法经冠状动脉造影证实的冠心病患者(CHD组)27例及年龄匹配的对照组30例,连续测量3个心动周期二尖瓣环4个位点的收缩期峰值位移(Ds)、瓣环连线中点最大位移(Mid)、Mid与左心室舒张期末最大纵径比值(Mid%)、收缩期达峰时间(T)、舒张早期位移(De)及舒张晚期位移(Da),求均值,计算Da/Dt(Dt=De+Da),并将Ds均值、Mid均值、Mid%均值与双平面Simpson法计算出的左心室射血分数(LVEF)及将Da/Dt与二尖瓣口血流频谱A/E峰值比作相关性分析。结果(1)与对照组相比,CHD组4个位点Ds、Mid、Mid%及其均值均降低(P<0.01),4个位点达峰时间及其均值均延长(P<0.05或P<0.01);(2)与对照组相比,CHD组4个位点De及其均值均降低(P<0.01),侧壁、前壁、下壁Da及4个位点Da均值均增高(P<0.05或P<0.01),Da/Dt增高(P<0.01);(3)对照组、CHD组Ds均值、Mid均值及Mid%均值与LVEF呈正相关(对照组:r=0.697,r=0.711,r=0.779,P<0.01;CHD组:r=0.707,r=0.703,r=0.789,P<0.01);(4)对照组、CHD组Da/Dt与A/E峰值比呈正相关(r=0.739,r=0.666,P<0.01)。结论TMAD新技术可以客观、方便地评价冠心病患者左心室功能。

    Abstract:

    Aim To evaluate the left ventricular systolic and diastolic function by automated motion tracking of mitral annular displacement (TMAD) in patients with coronary heart disease (CHD).Methods Twenty-seven CHD patients (group CHD) confirmed by coronary angiography and thirty age-matched normal controls were enrolled in this study.The parameters were obtained by TMAD which lasted at least three consecutive cardiac cycles: maximal systolic displacement (Ds),early diastolic displacement (De) and late diastolic displacement (Da) of the four points of mitral annulus,the time to peak systolic displacement (T),systolic displacement of the middle point (Mid) and its ratio to the length of left ventricle at end-diastole (Mid%),then separately to calculate the mean of foregoing numbers.And the Da/Dt ratio was calculated (Dt=De+Da).Then,the correlation between the mean of Ds,the mean of Mid,the mean of Mid% and left ventricular ejection fraction (LVEF) measured by biplane Simpson methods,between Da/Dt ratio and transmitral index E/A ratio were analyzed.Results (1)Compared with control group,the Ds,Mid,Mid% of four points,the mean of Ds,the mean of Mid and the mean of Mid% were decreased significantly (all P<0.01),the T of four points and the mean of T increased significantly (P<0.05 or P<0.01) in group CHD.(2)Compared with control group,the De of four points and the mean of De were decreased significantly (all P<0.01),the Da of lateral,anterior and inferior mitral annulus,the mean of Da of four points (P<0.05 or P<0.01) and Da/Dt ratio (P<0.01) increased significantly in group CHD.(3)In both two groups,the mean of Ds,the mean of Mid and the mean of Mid% show a positive correlation to LVEF (control group: r=0.697,r=0.711,r=0.779,P<0.01 group CHD: r=0.707,r=0.703,r=0.789,P<0.01).(4)In both two groups,Da/Dt ratio show a positive correlation to A/E ratio (control group: r=0.739,P<0.01 group CHD: r=0.666,P<0.01).Conclusion TMAD can access the left ventricular function in patients with CHD objectively and expediently.

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刘潇,陈永超,章仁品,彭超,吴满丽.组织运动二尖瓣环位移自动追踪技术评价冠心病患者左心室功能[J].中国动脉硬化杂志,2014,22(12):1241~1246.

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  • 收稿日期:2014-07-02
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