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应用多普勒左心射血等容时间指数综合评价慢性左心功能不全(PDF)

《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

期数:
2002年第6期
页码:
509-511
栏目:
影像学
出版日期:
2002-11-01

文章信息/Info

Title:
Applying total ejection isovolume index to evaluate left ventricular disfunction in patients with old myocardial infarction
作者:
章天乔
岩手医科大学第二内科,日本
Author(s):
ZHANG Tian-qiao
Dept.of the Second Internal Medicine of the Affiliated Hospital of Iwate Medical University,Japan
关键词:
左心射血等容时间指数; 心室功能; 左
Keywords:
total ejection isovolume index;  ventricular function; left
分类号:
R541.64
DOI:
-
文献标识码:
A
摘要:
目的 探讨应用多普勒左心射血等容时间指数(Total ejection isovolume index,Tei index)综合评价慢性左心功能不全的临床价值。方法 ①使用Agilent-5500型超声诊断仪,测定陈旧性心肌梗死(OMI)患者的二尖瓣血流图、肺静脉血流图、Tei index和左心射血分数(LVEF)。②选择LVEF(Biplane Simpson法)小于58%的OMI 36例,按二尖瓣血流图和肺静脉血流图结果分为收缩舒张功能障碍组(OMI-1组)和收缩舒张功能障碍而二尖瓣血流图假性正常组(OMI-2组);健康人22名作为对照组。结果 Tei index对照组为0.42±0.04,OMI-1组为0.73±0.16,OMI-2组为0.90±0.23。OMI-1,OMI-2组与对照组比较,均P<0.01;OMI-2组与OMI-1组比较,P<0.01。结论 Tei index可用于临床综合评价慢性左心功能不全,并且可作为鉴别二尖瓣血流图假性正常化的参考指标之一。
Abstract:
AMI To study on the clinical value of applying total ejection isovolume index (Tei index) to evaluate combined systolic and diastolic left ventricular(LV) disfunction.METHODS ①According to their mitral inflow and pulmonary vein flow profiles by routine echocardiography,36 patients with old myocardial infarction(OMI), whose LV ejection fraction(EF) was below 58%,were divided into two groups: OMI-1 group(systolic and diastolic LV disfunction without a pseudonormal mitral inflow) and OMI-2 group(systolic and diastolic LV disfunction with a pseudonormal mitral inflow) and 22 normal peoples served as controls.②A Doppler-derived Tei index, defined as the sum of isovolumetric contraction time and isovolumetric relaxation time divided by ejection time, were measured from LV outflow and mitral inflow profiles at the same time in the three groups.RESULTS ①Compared with controls, Tei index of OMI-1 and OMI-2 groups were significantly high(0.73±0.16, 0.90±0.23vs0.42±0.04,P<0.01).②Compared with OMI-1, Tei index of of OMI-2 group was significantly high(0.90±0.23vs0.73±0.16,P< 0.01).CONCLUSION Tei index is useful in evaluating global LV disfunction and allows simple and noninvasive differentiation of pseudonormal from normal transmitral flow pattern.

参考文献/References

[1] McKay RG, Pfeffer MA, Pasternark RC,et al. Left ventricular remodeling following myocardial infarction: a corollary to infarct expansion[J].Circulation, 1986, 74: 693-702

[2] Lenihan DJ. Mechanism,diagnosis, and treatment of diastolic heart failure[J].Am Heart J, 1995,130:153-166

[3] Pai RG,Buech GC. Newer Doppler measures of left ventricular diastolic function[J].Clin Cardiol,1996,19:277-279

[4]章天乔.应用肺静脉血流图结合二尖瓣血流图评价糖尿病左心室舒张功能[J].中国慢性病预防与控制杂志,1999,7 (1):17-19.

[5] Tei C. New index of combined systolic and diastolic myocardial performance: A simple and reproducible measure of cardiac function-A study in normals and cardiomyopathy[J].J Cardiol, 1995,26: 357-366.

[6] Tei C, Nishimura RA, Seward JB,et al. Noninvasive Doppler-derived myocardial performance index; Correlation with simultaneous measurements of cardiac catheterization measurements [J].J Am Soc Echocardiogr, 1997, 10:169-178.

备注/Memo

备注/Memo:
收稿日期：2001-11-28.
更新日期/Last Update: 2002-11-01