Qiao Wei, Zhang Xiao-ping, Qian Duan, Zheng Zhi-gang, Zhang Li-ping, Zheng Xiao-yun
Department of Senior Ward, China-Japan Friendship Hospital, Beijing 100029, China.
Zhonghua Yi Xue Za Zhi. 2007 Jun 26;87(24):1676-80.
To investigate the value of quantitative tissue velocity imaging (QTVI) echocardiography in the evaluation of cardiac function and the diagnosis of left heart failure.
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.
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 < or = 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 < or = 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%.
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.
探讨定量组织速度成像（QTVI）超声心动图在评估心功能及诊断左心衰竭中的价值。
30例心力衰竭（HF）患者，年龄66±12（39 - 86）岁，32例正常对照者，年龄66±12（40 - 82）岁，均接受常规超声心动图及QTVI检查。采用Simpson公式计算左心室射血分数（LVEF）。通过QTVI测定二尖瓣环后间隔、侧壁、前间隔、后壁、前壁及下壁节段的收缩期峰值速度（Vs）和收缩期位移（Ds），并计算平均Vs和平均Ds。比较HF患者与正常对照者的平均Vs和平均Ds值，以及HF患者治疗前后的平均Vs和平均Ds值。分析平均Vs和平均Ds与LVEF的相关性。
HF患者的平均Vs为2.8 cm/s±0.6 cm/s，显著低于正常对照者（6.4 cm/s±0.9 cm/s，P<0.01）。治疗后HF患者的平均Vs为3.5 cm/s±1.1 cm/s，显著高于治疗前（2.8 cm/s±0.6 cm/s，P<0.01）。HF患者的平均Ds为5.2 mm±1.5 mm，显著低于正常对照者（11.6 mm±1.5 mm，P<0.01）。治疗后HF患者的平均Ds为6.5 mm±2.0 mm，显著高于治疗前（5.2 mm±1.5 mm，P<0.01）。平均Vs和平均Ds与LVEF呈正相关（r = 0.87，P<0.01；r = 0.89，P<0.01）。诊断HF时，平均Vs的受试者操作特征（ROC）曲线下面积（AUC）为0.95。以平均Vs≤4.42 cm/s为诊断左心衰竭的切点，敏感性为97.5%，特异性为90.2%，准确率为95.1%。诊断HF时，平均Ds的ROC曲线下面积为0.96。以平均Ds≤8.49 mm为诊断左心衰竭的切点，敏感性为97.5%，特异性为87.8%，准确率为95.1%。
QTVI测定的二尖瓣环平均收缩期速度和平均收缩期位移有助于评估左心室收缩功能。对左心衰竭的诊断价值显著。
