| 义贺声,朱智明,高连如,张宁坤,赵文锐.负荷DTI二尖瓣环舒张期波形改变对心肌缺血的提示意[J].中国医学影像技术,2005,21(2):194~198 |
| 负荷DTI二尖瓣环舒张期波形改变对心肌缺血的提示意 |
| Changes of mitral annular dynamics during diastole response to dobutamine stress by Doppler tissue imaging: suggestion of myocardial ischemia |
| 投稿时间：2004-10-26 修订日期：2004-12-08 |
| DOI： |
| 中文关键词: 多普勒组织成像 负荷试验 二尖瓣 冠心病 心肌缺血 |
| 英文关键词:Doppler tissue imaging Stress test Mitral valve Coronary artery disease Myocardial ischemia |
| 基金项目: |
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| 中文摘要: |
| 目的 了解负荷DTI二尖瓣环舒张期波形改变对心肌缺血的提示意义。方法 利用DTI观测104例冠状动脉造影(CA)患者的二尖瓣环舒张期4个位点的e波与a波的比值在多巴酚丁胺应用前后的变化,并与CA结果进行比较。结果 基础状态下DTI二尖瓣环4个取样点的e/a均＜1.0时,冠心病的检出率较高,而二尖瓣环4个取样点的e/a均≥1.0时的冠脉病变率最低(P＜0.01);负荷条件下原本各点e/aann≥1.0的一些病例中出现部分取样点的e/aann＜1.0改变,其冠脉病变率增高或有增高的趋势(P＜0.05),而试验前后维持e/aann≥1.0波形的病例的冠脉病变率有下降的趋势。结论 负荷剂量下不同位点的e/aann发生变化使得DTI以 e/aann＜1.0为指标提示冠心病的准确度、灵敏度、特异度、阳性预测值和阴性预测值和以e/aann≥1.0为指标排除冠心病的准确度、特异度、阳性预测值均有所提高。 |
| 英文摘要: |
| Objective To understand the meaning of changes of mitral annular dynamics during diastole in diagnosing myocardial ischemia under the conditions of stress Doppler tissue imaging (DTI). Methods DTI studies including e/aann ratio of 104 patients, who had undergone coronary arteriography, were obtained from each of 4 mitral annular sites, as follows: inferoseptal and lateral sites from the apical 4-chamber view, anterior and inferior sites from the apical 2-chamber view. According to the sites of e/aann≥1.0 or ＜1.0 at rest, 104 cases were divided into 5 groups: groupⅠ, in which e/aann≥1.0 was shown at all the 4 sites; group Ⅱ, e/aann≥1.0 at 3 of the sites; group Ⅲ, e/aann≥1.0 was detected at 2 sites; group Ⅳ, there was only one site with e/aann≥1.0; group Ⅴ, e/aann ratios at all the sites were ＜1.0. Then, the groups above were further divided into several subgroups according to changes of the sites with e/aann≥1.0 after the stress DTI. Results The highest rate of coronary artery disease (CAD) was found in group Ⅴ at rest, while the lowest rate of CAD in group Ⅰ (P＜0.01). A tendency to have a high incidence of CAD was also noticed in the cases in which the e/aann ratios changed from ≥1.0 into ＜1.0 after the tress echocardiography. However, no matter whatever happened the e/aann ratios after the stress test, there still was a high incidence of CAD in group Ⅴ. Conclusion As changes of e/aann ratios at partial sites in some cases of CAD happened during the stress test, analysis of these changes could improve the efficacy of stress DTI in diagnosing myocardial ischemia. |
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