定量组织速度成像（QTVI）技术评价冠心病患者右心室局部及整体功能的研究
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摘要
目的:探讨应用定量组织速度成像(QTVI)技术在冠心病(CAD)患者右心室心肌局部及整体功能的应用价值。
方法:应用QTVI获取30例正常对照组、30例心绞痛组和30例心肌梗死组患者右心室心肌不同位点的时间间期,分析并比较三组人群间收缩期峰值速度(Vs)、快速充盈期峰值速度(Ve)、心房收缩期峰值速度(Va)、计算Ve/Va、测量等容收缩时间(ICT)、等容舒张时间(IRT)、射血时间(ET)、心室舒张充盈时间(DFT)、计算Q-Tei指数和Z指数,比较Q-Tei指数和Z指数存在的差异。应用脉冲多普勒测量PW-Tei指数。
结果:心绞痛组与正常对照组比较右心室Vs、Ve减低,Va升高,但差异无统计学意义,(P>0.05),Ve/Va比正常对照组减低,差异有统计学意义(P<0.05)。心梗组与正常对照组比较,右心室Vs、Ve、Ve/Va减低,Va升高,差异有统计学意义(P<0.05);心绞痛组与正常对照组比较右心室ICT、IRT延长、DFT缩短,但差异无统计学意义,(P>0.05),ET缩短、Q-Tei指数、PW-Tei指数升高、Z指数减低,差异有统计学意义(P<0.05);心梗组与正常对照组比较ICT、IRT延长、ET、DFT缩短,差异有统计学意义(P<0.05),Q-Tei指数、PW-Tei指数升高、Z指数减低,与正常对照组及心绞痛组比较差异均有统计学意义(P<0.05)。Q-Tei指数与PW-Tei指数呈高度正相关(r=0.763,P<0.05)。
结论: CAD患者右心室局部及整体的舒张及收缩功能受损,QTVI提供了一种精确、快速、无创地评价CAD患者右心室局部及整体舒张及收缩功能变化的新方法。
Objective : To investigate the value of quantitative tissue velocity imaging (QTVI) in assessing the Right ventricular (RV) regional and total function in patients with coronary artery disease (CAD) .
Methods : 30 normal subjects and 30 patients with angina and 30 patients with myocardial infarction were studied by QTVI, measured velocity of systole (Vs),early diastole velocity(Ve),lated diastole velocity (Va), Ve\Va, the RV isovolumetric contraction time(ICT), isorolumetric relaation time (IRT), the ejection (ET), diastole filling time (DFT), the Q-Tei index and Z index. obtained pw-Tei index form the pulse-wave Doppler.
Results: The RV Vs、Ve、Va had no difference in angina patients compared with normal subjects(P>0.05),Ve/Va was higher in patients with angina patients than that in normal group(P<0.05)The RV Vs、Ve、Ve/Va、was shorter, Va was higher in patients with myocardial infarction than that in normal group(P<0.05).The RV ICT and IRT, DFT had no difference in angina patients compared with normal subjects(P>0.05,Q-Tei index,PW-Tei index were higher and Z index was lower than that in normal group(P<0.05). The RV ICT,IRT was longer,ET,DFT was shorter in patients with myocardial infarction than that in normal group(P<0.05). Q-Tei index, PW-Tei index were higher and Z index was lower than that in normal group and angina(P<0.05). Q-Tei index showed significant positive correlation with PW-Tei index(r=0.763,P<0.05).
Conclusions: CAD caused right ventricular regional diastolic and systolic funetion impaired,QTVI is a sensitive,rapid,non-invasive method to assess the right ventricular regional diastolic and systolic function in CAD patients.
方法:应用QTVI获取30例正常对照组、30例心绞痛组和30例心肌梗死组患者右心室心肌不同位点的时间间期,分析并比较三组人群间收缩期峰值速度(Vs)、快速充盈期峰值速度(Ve)、心房收缩期峰值速度(Va)、计算Ve/Va、测量等容收缩时间(ICT)、等容舒张时间(IRT)、射血时间(ET)、心室舒张充盈时间(DFT)、计算Q-Tei指数和Z指数,比较Q-Tei指数和Z指数存在的差异。应用脉冲多普勒测量PW-Tei指数。
结果:心绞痛组与正常对照组比较右心室Vs、Ve减低,Va升高,但差异无统计学意义,(P>0.05),Ve/Va比正常对照组减低,差异有统计学意义(P<0.05)。心梗组与正常对照组比较,右心室Vs、Ve、Ve/Va减低,Va升高,差异有统计学意义(P<0.05);心绞痛组与正常对照组比较右心室ICT、IRT延长、DFT缩短,但差异无统计学意义,(P>0.05),ET缩短、Q-Tei指数、PW-Tei指数升高、Z指数减低,差异有统计学意义(P<0.05);心梗组与正常对照组比较ICT、IRT延长、ET、DFT缩短,差异有统计学意义(P<0.05),Q-Tei指数、PW-Tei指数升高、Z指数减低,与正常对照组及心绞痛组比较差异均有统计学意义(P<0.05)。Q-Tei指数与PW-Tei指数呈高度正相关(r=0.763,P<0.05)。
结论: CAD患者右心室局部及整体的舒张及收缩功能受损,QTVI提供了一种精确、快速、无创地评价CAD患者右心室局部及整体舒张及收缩功能变化的新方法。
Objective : To investigate the value of quantitative tissue velocity imaging (QTVI) in assessing the Right ventricular (RV) regional and total function in patients with coronary artery disease (CAD) .
Methods : 30 normal subjects and 30 patients with angina and 30 patients with myocardial infarction were studied by QTVI, measured velocity of systole (Vs),early diastole velocity(Ve),lated diastole velocity (Va), Ve\Va, the RV isovolumetric contraction time(ICT), isorolumetric relaation time (IRT), the ejection (ET), diastole filling time (DFT), the Q-Tei index and Z index. obtained pw-Tei index form the pulse-wave Doppler.
Results: The RV Vs、Ve、Va had no difference in angina patients compared with normal subjects(P>0.05),Ve/Va was higher in patients with angina patients than that in normal group(P<0.05)The RV Vs、Ve、Ve/Va、was shorter, Va was higher in patients with myocardial infarction than that in normal group(P<0.05).The RV ICT and IRT, DFT had no difference in angina patients compared with normal subjects(P>0.05,Q-Tei index,PW-Tei index were higher and Z index was lower than that in normal group(P<0.05). The RV ICT,IRT was longer,ET,DFT was shorter in patients with myocardial infarction than that in normal group(P<0.05). Q-Tei index, PW-Tei index were higher and Z index was lower than that in normal group and angina(P<0.05). Q-Tei index showed significant positive correlation with PW-Tei index(r=0.763,P<0.05).
Conclusions: CAD caused right ventricular regional diastolic and systolic funetion impaired,QTVI is a sensitive,rapid,non-invasive method to assess the right ventricular regional diastolic and systolic function in CAD patients.
引文
1.方凡,李泉水.脉冲多普勒组织成像在冠心病诊断中的应用.临床超声医学杂志,2004,6(3):172-174.
2.邵长久,王宽增,孟祥国.超声技术在冠心病诊断中的应用。中国分子心脏病学杂志,2005,5(2):510-512.
3.吴晓霞,智光.冠心病超声诊断技术新进展.世界极危重病医学杂志, 2006,3(2):1219-1223.
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5. Brodin Lars-Ake.Tissue Doppler a fundamental tool for para-metric imaging [J].Clin Physiol Funct Imaging,2004,24:147-155.
6. Edvardsen T,Gerber BI ,Garot T,et a1.Quantitative assess-ment of intrinsic regional myocardial deformation by Doppler strain rate echocardiography in humans:validation againdtthree-dimensional tagged magnetic resonance imaging [J].Cir-culation,2002,106:50-56.
7.黄朴忠,王晓洋,李焱,等.定量组织速度图对冠心病室壁运动异常的研究[J].中国超声医学杂志,2001,17(10):729-732.
8. Bart WL,Maarten-Jan M,Jae K.et a1.Spectral pulsed tissuedoppler imaging in diastole:A tool to increase our insight inand assessment of diastolic relaxation of the left ventricle[J].Am Hcart J,2003,146:411- 419.
9. .Nikitin NP,Witte KKA.Thackray SDR,et a1.Longitudinal ventricular function:Normal values of atrioventricular annular and myocardial velocities measured with quantitative two-di-mensional color doppler tissue imaging[J]. J Am Soc Echocar-digr,2003,16:906-921.
10.孙辉,金丽娟,崔林,等.定量组织速度成像对心肌缺血的评估.中国超声医学杂志,2004,20(4):283-285.
11. Edvardsen T,Urheim S,Skulstad H.et a1 . Quantification ofleft ventricular systolic function by tissue doppler Echocardiography.Added value of measuring pre- andpostejection veloci-ties in ischemic myocardium[J].Circulation, 2002, 105: 2071-2077.
12. Penicka M.Bartunek J,Wijns W,et a1.Tissue doppler ima-ging predicts recovery of left ventricular function after reca-nalization of an occluded coronary artery [J].J Am Coil Cardi-ol,2004, 43:85-91.
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20. Baykan M ,Yilmaz R.Celik S,et a1. Assessment of left ven-tricular systolic and diastolic function by Doppler tissue imaging in patients with preinfarction angina.J Am Soc Echocardiogr,2003,16(10):1024-1030.
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1.方凡,李泉水.脉冲多普勒组织成像在冠心病诊断中的应用临床超声医学杂志2004,6(3);172-174.
2.吴晓霞,智光.冠心病超声诊断技术新进展世界极危重病医学杂志, 2006,3(2):1219-1223.
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2.邵长久,王宽增,孟祥国.超声技术在冠心病诊断中的应用。中国分子心脏病学杂志,2005,5(2):510-512.
3.吴晓霞,智光.冠心病超声诊断技术新进展.世界极危重病医学杂志, 2006,3(2):1219-1223.
4. Lind B.Nowak j,Vander Linden,et a1.Analysis of tempora1 requirements for myo- cardial tissuevelocityimaging[J].Eur JEchocardiogr,2002,3:214-219.
5. Brodin Lars-Ake.Tissue Doppler a fundamental tool for para-metric imaging [J].Clin Physiol Funct Imaging,2004,24:147-155.
6. Edvardsen T,Gerber BI ,Garot T,et a1.Quantitative assess-ment of intrinsic regional myocardial deformation by Doppler strain rate echocardiography in humans:validation againdtthree-dimensional tagged magnetic resonance imaging [J].Cir-culation,2002,106:50-56.
7.黄朴忠,王晓洋,李焱,等.定量组织速度图对冠心病室壁运动异常的研究[J].中国超声医学杂志,2001,17(10):729-732.
8. Bart WL,Maarten-Jan M,Jae K.et a1.Spectral pulsed tissuedoppler imaging in diastole:A tool to increase our insight inand assessment of diastolic relaxation of the left ventricle[J].Am Hcart J,2003,146:411- 419.
9. .Nikitin NP,Witte KKA.Thackray SDR,et a1.Longitudinal ventricular function:Normal values of atrioventricular annular and myocardial velocities measured with quantitative two-di-mensional color doppler tissue imaging[J]. J Am Soc Echocar-digr,2003,16:906-921.
10.孙辉,金丽娟,崔林,等.定量组织速度成像对心肌缺血的评估.中国超声医学杂志,2004,20(4):283-285.
11. Edvardsen T,Urheim S,Skulstad H.et a1 . Quantification ofleft ventricular systolic function by tissue doppler Echocardiography.Added value of measuring pre- andpostejection veloci-ties in ischemic myocardium[J].Circulation, 2002, 105: 2071-2077.
12. Penicka M.Bartunek J,Wijns W,et a1.Tissue doppler ima-ging predicts recovery of left ventricular function after reca-nalization of an occluded coronary artery [J].J Am Coil Cardi-ol,2004, 43:85-91.
13. Jensen J,Brodin LA,Lind B,et a1.Detoriation in peak systolicvelocity is closely related to ischemia during angioplasty:avectorcardigraphic and tissue Doppler imaging[J].Eur J Ech-ocardiogr,2002,100:137-143.
14.周欣,邓林云.定量组织速度成像在冠心病诊断中的应用.江西医学院学报, 2005, 45(5) :171-173.
15. Rusconi C.Diastolic function of the left ventricle and congestive heart failure with normal systolic function hal Heart J,2000,1(10 Supp1):1273-I280.
16. Redfield MM ,Jacobsen SJ,Burnett JC Jr,et a1.Burden of svsto1-ic and diastolic ventricular dysfunction in the community:appre-ciating the scope of the heart failure epidemic.JAMA,2003,289 (2):194-202.
17.阮雯,舒先红.评价冠心病患者左心室舒张功能的超声新方法.中国临床医学, 2004,11(6):1170-1172.
18. Waggoner AD,Bierig SM. Tissue Doppler imaging:a usefulech0cardi0graphic method for the cardiac sonographer to assess systolic and diastolic ventricular function. J Am Soc Ech0cardi0-gr,2002,15(5):478-482.
19.王莎莎,吴晓岩,袁彬彬,等.定量组织速度成像对冠心病节段舒张功能的临床评价.解放军医学杂志, 2003,28(2):171-173.
20. Baykan M ,Yilmaz R.Celik S,et a1. Assessment of left ven-tricular systolic and diastolic function by Doppler tissue imaging in patients with preinfarction angina.J Am Soc Echocardiogr,2003,16(10):1024-1030.
21. Tei C,Ling LH.Hodge D0,et a1.J Cardio1.1995, 26(6):357- 366.
22. Tei C, Karl SD, Eavid OH, et al. Doppler echocardiographic index for assessment of global right ventricular function .J Am Soc Echocardiogr, 1996, 9(9): 838-847.
23.陈柏华,李沿江.多普勒超声Tei指数估测心脏整体功能的研究.实用临床医学,2007, 8(12 ): 134-138.
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