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Quantification of the myocardial response to low-dose dobutamine using tissue Doppler echocardiographic measures of velocity and velocity gradient.使用组织多普勒超声心动图测量速度和速度梯度来量化心肌对低剂量多巴酚丁胺的反应。
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脉冲组织多普勒成像可检测出无症状重度二尖瓣反流患者的早期心肌功能障碍。

Pulsed tissue Doppler imaging detects early myocardial dysfunction in asymptomatic patients with severe mitral regurgitation.

作者信息

Agricola E, Galderisi M, Oppizzi M, Schinkel A F L, Maisano F, De Bonis M, Margonato A, Maseri A, Alfieri O

机构信息

Division of Non-Invasive Cardiology, San Raffaele Hospital, IRCCS, Milan, Italy.

出版信息

Heart. 2004 Apr;90(4):406-10. doi: 10.1136/hrt.2002.009621.

DOI:10.1136/hrt.2002.009621
PMID:15020516
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC1768146/
Abstract

OBJECTIVE

To assess whether tissue Doppler myocardial imaging (TDI) indices can predict postoperative left ventricular function in patients with mitral regurgitation (MR) after surgical correction.

METHODS

84 patients (mean (SD) age 54.3 (10.8) years) with asymptomatic severe MR, an end systolic diameter < 45 mm, and an ejection fraction (EF) > 60% were subdivided in two groups: 43 patients with a postoperative EF reduction < 10% (group 1) and 41 patients with a postoperative EF reduction > or = 10% (group 2).TDI systolic indices of the lateral annulus were analysed preoperatively to assess myocardial systolic wave (Sm) velocity, myocardial precontraction time (PCTm), myocardial contraction time (CTm), and the PCTm:CTm ratio.

RESULTS

Postoperative EF decreased significantly (from 67 (5)% to 60 (5.5)%, p = 0.0001). Group 2 had a higher PCTm, CTm, and PCTm:CTm ratio and a lower Sm velocity than group 1 (PCTm 100.4 (19) ms v 82 (21.8) ms, p = 0.004; CTm 222 (3.1) ms v 215 (2.3) ms, p = 0.01; PCTm:CTm 0.45 (0.08) v 0.38 (0.09), p = 0.001; Sm velocity 10.4 (1.1) cm/s v 13 (1.3) cm/s, p = 0.0001). Multivariate regression analysis showed that the combination of PCTm:CTm ratio > or = 40 ms and Sm velocity < or = 10.5 cm/s was the main independent predictor of postoperative EF reduction > or = 10% (sensitivity 78%, specificity 95%).

CONCLUSIONS

TDI systolic indices can predict postoperative left ventricular function in patients with asymptomatic MR undergoing surgical correction.

摘要

目的

评估组织多普勒心肌成像（TDI）指标能否预测二尖瓣反流（MR）患者手术矫正术后的左心室功能。

方法

84例无症状重度MR患者（平均（标准差）年龄54.3（10.8）岁），收缩末期直径<45 mm，射血分数（EF）>60%，被分为两组：43例术后EF降低<10%的患者（第1组）和41例术后EF降低≥10%的患者（第2组）。术前分析外侧瓣环的TDI收缩期指标，以评估心肌收缩波（Sm）速度、心肌预收缩时间（PCTm）、心肌收缩时间（CTm）以及PCTm:CTm比值。

结果

术后EF显著降低（从67（5）%降至60（5.5）%，p = 0.0001）。第2组的PCTm、CTm和PCTm:CTm比值高于第1组，Sm速度低于第1组（PCTm 100.4（19）ms对82（21.8）ms，p = 0.004；CTm 222（3.1）ms对215（2.3）ms，p = 0.01；PCTm:CTm 0.45（0.08）对0.38（0.09），p = 0.001；Sm速度10.4（1.1）cm/s对13（1.3）cm/s，p = 0.0001）。多因素回归分析显示，PCTm:CTm比值≥40 ms且Sm速度≤10.5 cm/s的组合是术后EF降低≥10%的主要独立预测因素（敏感性78%，特异性95%）。

结论

TDI收缩期指标可预测接受手术矫正的无症状MR患者术后的左心室功能。