组织运动瓣环位移技术对慢性心力衰竭患者心室间同步性评价

摘要

Objective To evaluate the value of Tissue Mitral Annular Displacement (TMAD) in the assessment of interventricular synchronization in patients with chronic heart failure(CHF). Methods Thirty nine CHF cases and thirty healthy cases were investigated using echocardiography. To obtain image of apical four-chamber view and Aortic flow spectrum, Pulmonary artery flow spectrum. PTtv, PTmv and APTtv-mv were measured by the technique of TMAD. APEI, PPEI and 1VD were measured by the technique of PW. All parameter were compared between two groups, and the linear correlations between APEI and PTtv, PPEI and PTmv, and IVD and APTtv-mv were calculated. Results Compared with control group, the PPEI, APEI, PTtv and PTmv were significantly increased In CHF group (P<0.001); The IVD and APTtv-mv were significantly increased compared with control group (P<0.01). The linear correlation ( r) was found to be higher between IVD and ?PTtv-mv ( r = 0. 482, R2 = 0. 407, P = 0. 000), PPEI and PT-TV(r=0. 446.R2 =0. 199, P = 0. 000), APEI and PT-MV(r=0. 620,R2 =0. 384 ,P = 0. 000) respectively. Conclusions APTtv-mv were significantly increased compared with control group in patients with CHF. APTtv-mv was measured by TMAD could be a new method for assessment interventricular synchronization.%目的 探讨组织运动瓣环位移(TMAD)技术在评价慢性充血性心力衰竭(CHF)患者心室间同步性的应用价值.方法 选择我院39例CHF患者及30例健康成人行超声心动图检查,获取心尖四腔观二维灰阶图像以及主动脉瓣上、肺动脉瓣上血流频谱,采用TMAD技术测量二尖瓣环(MV)、三尖瓣环(TV)收缩期位移的达峰时间(PT),获得其差值△PTtv-mv,采用脉冲多普勒测量主动脉射血前期时间(APED、肺动脉射血前期时间(PPEI)以及二者差值IVD.比较两组上述参数,并行PPEI与PTtv、APEI与PTmv以及APTtv-mv与IVD的相关性分析.结果 与正常对照组比较,CHF组PPEI、APEI以及PTtv与PTmv均延长(P＜0.001),CHF组IVD以及△PTtv-mv均较对照组显著延长(P＜0.01)；相关性研究发现,PPEI与PT-TV呈线性正相关(r=0.446,R2 =0.199,P=0.000),APEI与PT-MV呈线性正相关(r=0.620,R2=0.384,P=0.000)；IVD与△PTtv-mv成线性正相关(r=0.482,R2=0.407,P＝0.000).结论 CHF患者APTtv-mv显著延长,TMAD测量△PTtv-mv可以作为CHF患者左右室同步性评价的新指标.