[组织多普勒超声心动图和Tei指数评估右心室心肌梗死患者右心室功能]

[Evaluation of right ventricular function by tissue Doppler echocardiography and Tei index in right ventricular myocardial infarction].

作者信息

Fan Ying, Shen Jing-xia, Yang Shu-sen, Xiu Chun-hong, Wang Lan-feng, Xue Feng-hua, Huang Yong-lin

机构信息

Department of Cardiac Medicine, the First Hospital, Harbin Medical University, Harbin 150001, China.

出版信息

Zhonghua Nei Ke Za Zhi. 2005 Mar;44(3):180-3.

PMID:15840255

Abstract

OBJECTIVE

With tissue Doppler imaging and right ventricular Tei index, right ventricular function in patients with right ventricular myocardial infarction (RVMI) was assessed.

METHOD

51 patients admitted to coronary care units and diagnosed as acute inferior myocardial infarction were further studied with the ECG criterion of ST segment elevation >or= 1mm in V(4R) to establish the diagnosis of RVMI. 23 patients were thus diagnosed as RVMI and 28 patients not. 20 healthy subjects served as controls. Clinical and echocardiography index were recorded. Peak systolic and peak early and late diastolic velocities (Sm, Em, Am) and Em/Am were acquired from the apical four-chamber view at the lateralside of tricuspid annulus, the septal side of the tricuspid annulus and the RV free mid-wall using DTI. Interval between tricuspid closing and reopening and ejection time (ET) from parasternal short-axis view were recorded by pulse-wave Doppler. RV Tei index was calculated.

RESULTS

Sm and Em at the lateral side of tricuspid annulus and the RV free mid-wall reduced significantly in patients with RVMI as compared with those without RVMI and healthy individuals (Sm at the lateral (7.0 +/- 2.0) cm/s vs (8.7 +/- 1.9) cm/s and (10.6 +/- 2.1) cm/s, P < 0.01; Em at the lateral (6.3 +/- 1.9) cm/s vs (7.9 +/- 1.8) cm/s and (9.6 +/- 1.9) cm/s, P < 0.01; Sm at the RV free mid-wall (6.4 +/- 1.9) cm/s vs (8.0 +/- 1.9) cm/s and (9.4 +/- 2.0) cm/s, P < 0.05; Em at the RV free mid-wall (6.1 +/- 2.0) cm/s vs (7.6 +/- 2.0) cm/s and (9.2 +/- 2.3) cm/s, P < 0.05). RV Tei index in patients with RVMI also increased as compared with that in the other two groups (0.65 +/- 0.19 vs 0.40 +/- 0.15 and 0.26 +/- 0.10; P < 0.01).

CONCLUSIONS

The evaluation of velocities at the lateral side of tricuspid annulus and the RV free mid-wall using DTI and RV Tei index provides a noninvasive and rapid method for assessing right ventricular function in patients with RVMI.

摘要

目的

采用组织多普勒成像和右心室Tei指数评估右心室心肌梗死（RVMI）患者的右心室功能。

方法

对51例入住冠心病监护病房且诊断为急性下壁心肌梗死的患者，根据V（4R）导联ST段抬高≥1mm的心电图标准进一步研究以确立RVMI诊断。其中23例被诊断为RVMI，28例未被诊断为RVMI。20名健康受试者作为对照。记录临床和超声心动图指标。使用DTI从三尖瓣环外侧、三尖瓣环间隔侧和右心室游离壁中层获取三尖瓣环收缩期峰值速度、舒张早期和晚期峰值速度（Sm、Em、Am）以及Em/Am。通过脉冲波多普勒记录胸骨旁短轴视图中三尖瓣关闭与重新开放之间的时间间隔以及射血时间（ET）。计算右心室Tei指数。

结果

与未发生RVMI的患者和健康个体相比，RVMI患者三尖瓣环外侧和右心室游离壁中层的Sm和Em显著降低（三尖瓣环外侧Sm：（7.0±2.0）cm/s对比（8.7±1.9）cm/s和（10.6±2.1）cm/s，P<0.01；三尖瓣环外侧Em：（6.3±1.9）cm/s对比（7.9±1.8）cm/s和（9.6±1.9）cm/s，P<0.01；右心室游离壁中层Sm：（6.4±1.9）cm/s对比（8.0±1.9）cm/s和（9.4±2.0）cm/s，P<0.05；右心室游离壁中层Em：（6.1±2.0）cm/s对比（7.6±2.0）cm/s和（9.2±2.3）cm/s，P<0.05）。与其他两组相比，RVMI患者的右心室Tei指数也升高（0.65±0.19对比0.40±0.15和0.26±0.10；P<0.01）。