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.
引文
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