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目的:探讨组织多普勒成像(TDI)技术评价射血分数正常的心衰患者左室长轴功能特点。方法:选取30名健康人(Ⅰ组)、EF>50%的心衰患者30名(Ⅱ组)和EF<50%的心衰患者30名(Ⅲ组)作为研究对象,采用TDI在二尖瓣环室间隔(ivs)、侧壁(l)、前壁(a)、后壁(p)、下壁(d)测量其Sm、DSm、IVCTm、TSm、Em、Am、IVRTm、TEm等指标。结果:Ⅰ组、Ⅱ组、Ⅲ组DSm、Sm逐渐减低,(P<0.05);而IVCTm、TSm逐渐升高(P<0.05);IVRTm、TEm在Ⅰ组、Ⅲ组、Ⅱ组逐渐升高(P<0.05);DSm及TEm在诊断EF>50%心衰患者心功能的指标中ROC曲线下面积最大,同样DSp及TEp在五个位点中ROC曲线下面积最大。结论:射血分数正常的心衰患者存在收缩减低;DSm及TEm是诊断EF>50%心衰患者心功能比较有效的指标;后壁是诊断的最佳位点。
Objective: To investigate the features of left ventricular long axis in patients with normal heart failure with ejection fraction assessed by tissue Doppler imaging (TDI). Methods: Thirty healthy subjects (group Ⅰ), 30 (group Ⅱ) patients with heart failure (EF> 50%) and 30 (group Ⅲ) patients with heart failure (EF <50%) were enrolled in this study. The indexes of Sm, DSm, IVCTm, TSm, Em, Am, IVRTm and TEm were measured by means of interlobular septum (IVs), lateral wall (1), anterior wall (a), posterior wall (p) and inferior wall . Results: The levels of DSm and Sm in group Ⅰ, group Ⅱ and group Ⅲ decreased gradually (P <0.05), but the levels of IVCTm and TSm increased (P <0.05); the levels of IVRTm and TEm increased in group Ⅰ, group Ⅲ and group Ⅱ (P <0.05). The areas under the ROC curve of DSm and TEm were the highest in the indexes of heart function in patients with EF> 50% of heart failure. Similarly, the area under the ROC curve of DSp and TEp was the largest among the five sites. CONCLUSIONS: Systolic decline is found in patients with normal ejection fraction of heart failure. DSm and TEm are more effective indicators for diagnosing heart function in patients with EF> 50% heart failure. The posterior wall is the best site for diagnosis.