二尖瓣环位移参数对高血压患者左室舒张功能的评估

摘要

目的 探讨超声心动图二尖瓣环舒张期位移参数对高血压患者左室舒张功能的评估,比较组织速度显像(doppler velocity imaging,DVI)和组织追踪显像(tissue tracking imaging,TTI)对二尖瓣环运动的观察.方法 根据左室心肌质量指数(left ventricular mass index,LVMI)选取原发性高血压左室肥厚患者27例、原发性高血压LVMI正常患者28例和正常对照组27例,所有对象均行常规超声心动图检查,测量并计算传统评估左室舒张功能的各项指标,分别使用DVI和TTI测得二尖瓣环间隔侧的舒张期总位移SZ,舒张早期、晚期的位移(SE、SA)及其占总位移的百分比(SE％、SA％)和舒张早期、晚期二尖瓣环运动的平均速度(VE、VA),计算SE/SA和VE/VA.结果 3组间二尖瓣环舒张期位移参数SZ、SE、SA、SE％、SA％、VE、VA、SE/SA、VE/VA差异有统计学意义(P＜0.05);组织追踪显像比组织速度显像所得的舒张期二尖瓣环位移参数标准差更小,与左室舒张功能分纫间的相关性更高.结论 超声心动图二尖瓣环舒张期位移参数可以反映左室的舒张功能,组织追踪显像对二尖瓣环运动的观察优于组织速度显像.%Objective To study the clinical value of the displacement parameters of mitral annulus in diastole for the assessment of the left ventricular diastolic function by echocardiogram in patients with essential hypertension. Methods According to left ventricular mass index (LVMI) , fifty -five patients with essential hypertension were divided into left ventricular hypertrophy group and LVMI normal group, with twenty - seven healthy subjects as control. All subjects underwent routine echocardiography examination. Conventional diastolic function indexes were measured and calculated. The total displacement (SZ) , the displacement of the early and late diastole ( SE, SA) with the displacement percentage (SE% , SA% ) and the mean velocity of mitral annulus in the early and late diastole (VE, VA) were measured by both Doppler Velocity Imaging (DVI) and Tissue Tracking Imaging (TTI). Results The difference of SZ, SE, SA, SE% , SA% , VE, VA , SE/SA and VE/VA were statistically significant ( P < 0. 05 ) . TTI got the lower standard deviation of displacement parameters and the better relevancy with diastolic function classification compared with DVI. Conclusion The displacement parameters of mitral annulus can reflect diastolic function of left ventricular. TTI plays better than DVI in observing the movements of mitral annulus.