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1、心肌梗死患者左室局域舒張功能的運動幅度成像【摘要】目的探索冠心病患者左心室舒張各期局部心肌運動幅度成像特點及其評價左心室局域舒張功能的可能性。方法對54例前壁心肌梗死病人(MI組)和78例正常對照者(NOR組)左室心肌進行組織多普勒成像檢查。記錄心尖二腔動態(tài)圖像,應用運動幅度成像描記技術獲取左室各階段心肌同步幅度曲線,測量等容舒張期(IR)、快速充盈期(RF)、緩慢充盈期(SF)、心房收縮期(AC)局部心肌速度變化幅度,對兩組結(jié)果進行對比分析。結(jié)果在整個舒張期,正常對照組從前壁心尖、中間到心底部,幅度呈正值逐漸減小的梯度變化。MI組梯度變化規(guī)律消失,梗死區(qū)域幅度為負值。在等容舒張期,正常
2、組為一個較平緩的下降波97.44%(76/78)。MI組則有50%(27/54)為下降波(P<0.05)。在快速充盈期,對照組有97.44%(76/78)為快速下降的波;MI組梗死區(qū)域運動幅度為負值(P<0.001)。在緩慢充盈期,正常組多數(shù)為靠近基線的水平波;而在MI組,無明顯的水平波段(P<0.05)。結(jié)論局部心肌缺血梗死導致主動舒張期的局部心肌運動幅度顯著異常。運動幅度成像能敏感、直觀、無創(chuàng)地定量評價左心室局域舒張功能?!娟P鍵詞】運動幅度成像心肌梗死舒張功能局域心室 Abstract:ObjectiveTodetectthedistanceimagingfeat
3、uresofregionalwallabnormalitiesinpatientswithcoronaryarterydiseaseduringeachdiastolicperiod,aswellasthepossibilitytoevaluateregionalleftventriculardiastolicfunction.MethodsAtotalof54patientswithanteriormyocardialinfarction(MIgroup)and78normalsubjects(NORgroup)underwentDopplertissueimaging,whichwa
4、sperformedin2chamberviewbydistanceimagingsynchronously.ResultsInNORgroup,Dvalueshowedagraduallyincreasingpositivevaluefromtheapextomiddleandtobaseofleftventricle,whileinMIgroup,suchfeaturedisappearedanditwasnegativeintheinfarctedarea.Inisovolumicrelaxationperiod,thepalliativelydownwardwaveappear
5、edin97.44%(76/78)ofthesubjectsinNORgroup,andin50.00%(27/54)ofthepatientsinMIgroup(P<0.05).Inrapidfillingperiod,bothNORandMIgroupsshoweddownwardandsteepwaves,butinMIgroup,thegradientruledisappearedandDvaluewasnegativeintheinfarctedarea(P<0.001).Inslowfillingperiod,comparedwithNORgroupwhichsh
6、owedhorizontalwave,MIgrouphadnoobviouslyhorizontalwaves(P<0.05).ConclusionRegionalmyocardialischemiaandinfarctioncancausesignificantregionaldiastolicwallabnormalitiesofdistanceinactivediastolicphase.Regionaldiastolicwallmotionabnormalitiescanbeevaluatedquantitativelyandsynchronouslywithhighsen
7、sitivitybydistanceimagingwhichhasthepotentialvalueintheevaluationofdiastolicfunction.4 Keywords:distanceimaging;myocardialinfarction;diastolicabnormality;regionalventricle 冠心病早期左心室局域舒張功能異常早已被動物和臨床試驗證實[1]。但是由于方法和技術的限制