摘要
目的探讨定量组织速度成像(QTVI)技术对心功能的评价作用及其在诊断左心哀竭中的价值。方法对30例左心衰竭患者及32例止常人行常规超声心动图检查,以简化双平面Simpson 法计算出左室射血分数(LVEF);使用 QTVI 技术,测量左室壁二尖瓣环6个位点的收缩期峰值速度(Vs)、收缩期最大位移(Ds)。比较心衰组与正常对照组、心哀组治疗前与治疗后的二尖瓣环6个位点平均 Vs、平均 Ds,并将平均 Vs、平均 Ds 与 INEF 做相关性分析,探讨 QTVI 技术对心功能的评价作用及其对左室收缩性心力衰竭的诊断价值。结果二尖瓣环6个位点平均 Vs,心衰组明显低于正常对照组[(2.8±0.6)cm/s vs(6.4±0.9)cm/s,P<0.01],心衰组治疗后比治疗前显著升高[(3.5±1.1)cm/s vs(2.8±0.6)cm/s,P<0.01];二尖瓣环6个位点平均 Ds,心衰组显著低于正常对照组[(5.2±1.5)mm vs(11.6±1.5)mm,P<0.01],心衰组治疗后比治疗前显著升高[(6.5±2.0)mm vs(5.2±1.5)mm,P<0.01]。二尖瓣环6个位点平均 Vs、平均 Ds 与 LVEF 呈显著正相关(r 分别为0.87,0.89,均 P<0.01)。左室壁二尖瓣环6个位点平均 Vs 在诊断左心衰竭的受试者工作特征曲线下面积为0.95。以4.42 cm/s 为界值,二尖瓣环6个位点平均 Vs 诊断左心衰竭的敏感性为97.5%,特异性为90.2%,准确度为95.1%。左室壁二尖瓣环6个位点平均收缩期最大位移Ds 在诊断左心衰竭的受试者工作特征曲线下面积为0.96。以8.49 mm 为界值,二尖瓣环6个位点平均Ds 诊断左心衰竭的敏感性为97.5%,特异性为87.8%,准确度为95.1%。结论 QTVI 技术测定的二尖瓣环6个位点的平均 Vs、平均 Ds 可以评价左心室收缩功能,对左心衰竭有重要的诊断价值。
Objective To investigate the value of quantitative tissue velocity imaging （QTVI） echocardiography in the evaluation of cardiac function and the diagnosis of left heart failure. Methods 30 heart failure（HF） patients, aged 66± 12 （39-86）, and 32 normal controls, 66 ± 12 （40-82） underwent conventional echocardiography, and QTVI. Left ventricular ejection fraction （LVEF） was calculated by Simpson＇s formula. Mitral annulus peak systolic velocity （Vs） and systolic displacement （Ds） from posteroseptal, lateral, anteroseptal, posterior, anterior, and inferior segments were determined by QTVI, and the mean Vs and Ds were calculated. The values of mean Vs and Ds of the HF patients and those of the normal controls, and the values of mean Vs and Ds of the HF patients before and after treatment were compared. The correlation of the mean Vs and Ds with LVEF was analyzed. Results The mean Vs of the HF patients was 2.8 cm/s ＋ 0.6 cm/s, significantly lower than that of the normal controls （6.4 cm/s ± 0.9 cm/s, P〈0.01）. The mean Vs of the HF patients after treatment was 3.5 cm/s± 1, 1 cm/s, significantly higher than that before treatment （2.8 cm/s ± 0.6 cm/s, P 〈0.01 ）. The mean Ds of the HF patients was 5.2 mm ± 1.5 mm, significantly lower than that of the normal controls （ 11.6 mm ± 1.5 mm, P 〈 0.01 ）. The mean Ds of the HF patients after treatment was 6.5 mm ± 2.0 mm, significantly higher than that before treatment（5.2 mm＋ 1.5 mm, P 〈0.01 ）. The mean Vs and mean Ds were positively correlated with LVEF （r =0. 87, P 〈 0.01, and r = 0.89, P 〈 0.01 ）. The area under the curve （AUC） of receiver operator characteristic （ROC） was 0.95 for the mean Vs to diagnose HF. The mean Vs≤4.42 cm/s was used as a cut-off point to diagnosis left HF with a sensitivity of 97.5% a specificity of 90.2% , and an accuracy rating of 95.1%. The AUC of ROC was 0.96 for the mean Ds to diagnose HF. The mean Ds≤8.49 mm was used as a cut-off point to diagnose left HF with a sensitivity of 97.5% , a specificity of 87.8% , and an accuracy rating was 95. 1%. Conclusion The mean systolic velocity and mean systolic displacement of mitral annulus determined by QTVI help evaluate the left ventricular systolic function. The value of the diagnosis is significant in left HF.
出处
《中华医学杂志》
CAS
CSCD
北大核心
2007年第24期1676-1680,共5页
National Medical Journal of China
关键词
心力衰竭
充血性
二尖瓣
超声检查
Heart failure, congestive
Mitral valve
Ultrasonography
