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目的 采用组织多普勒显像(TDI)技术评价左室肥厚(LVH)患者二尖瓣环舒张中期心肌速度曲线的特点及临床价值.方法 采用常规多普勒对168例LVH患者进行检查,测定二尖瓣舒张早期血流速度峰值(E)、舒张中期血流峰值速度(L)和舒张晚期血流峰值速度(A峰);采用TDI技术测定二尖瓣环侧壁或间壁收缩期运动速度(Sa)、舒张早期二尖瓣环运动速度(Ea)、舒张中期二尖瓣环运动速度(La)和舒张晚期二尖瓣环运动速度(Aa).结果 168例LVH患者中,56例(33%)发现有La,而且测定部位多见于二尖瓣环侧壁;42例(25%)发现有舒张中期跨二尖瓣血流L,La的存在预示左室充盈压的增加,有进一步发生心力衰竭(HF)的危险性.而当L与La相关时,发生HF的危险性增加.结论 LVH患者中多数可探测到舒张中期心肌速度La曲线,尤其在瓣环侧更容易检测到,它的存在,特别是与跨二尖瓣舒张中期血流峰值速度相关时,预示有左室充盈压增加和发生HF事件的危险性.“,”Objective To explore the features and clinical effectiveness of application of TDI (Tissue Doppler Imaging) in evaluation of mid-diastolic mitral annular velocity curve in patients with LVH (Left Ventricular Hypertrophy). MethodsConventional Doppler imaging was performed in 168 LVH patients to measure the indexes of early-diastolic (E), mid-diastolic (L), late-diastolic (A) blood lfow velocities of mitral valves. While, TDI was applied to measure the systolic motion velocity (Sa) of the lateral or septal wall of mitral valve annulus as well as the early-diastolic (Ea), mid-diastolic (La), late-diastolic (Aa) mitral annular motion velocity.Results Among all the 168 patients with LVH, 56 cases(33%) were identified with La especially in the lateral wall of mitral valve annulus; whereas mid-diastolic trans-mitrial blood lfow L was found in 42 (25%) cases. La indicated the increase of left ventricular iflling pressure and the risks of further HF (Heart Failure). When La was associated with the L, the risks of HF would be increased further.Conclusion La was frequently observed in patients with LVH, especially at the lateral annulus. Its presence might predict the increase of left ventricular iflling pressure and potential risks for HF events, particularly when it was associated with mid-diastolic trans-mitral blood flow velocity.