Yazici Hüseyin Uğur, Sen Nihat, Tavil Yusuf, Hizal Fatma, Turfan Murat, Poyraz Fatih, Boyaci Bülent, Cengel Atiye
Gazi Universitesi Tip Fakültesi, Kardiyoloji Anabilim Dali, Beşevler, Ankara, Türkiye.
Anadolu Kardiyol Derg. 2009 Dec;9(6):467-72.
The aim of the study was to compare diagnostic accuracy of tissue Doppler imaging (TDI) and conventional Doppler echocardiography in diagnosis of left ventricular diastolic dysfunction in patients with cardiac syndrome X.
Our study was designed as cross-sectional study. In our study, we compared 35 patients with cardiac syndrome X (19 female, mean age 47.2+/- 7.3 years) with 33 healthy persons as control group (18 female, mean age 49.5+/- 7.1 years) with no coronary artery disease and having no ischemic complaints or findings at exercise test. Left ventricular systolic function was found by considering mean values of modified Simpson method for left ventricular ejection fraction and TDI assessment of systolic wave peak velocity. The diastolic function of left ventricle was assessed with conventional echocardiography and TDI. Unpaired t test for independent samples or Mann-Whitney U test were used for comparison of continuous variables, Chi square test - for comparison of categorical variables. To define the capability of predicting diastolic dysfunction for conventional Doppler echocardiography and tissue Doppler imaging ROC curve analysis was applied.
Left ventricular ejection fraction and systolic wave peak velocity were similar for both groups. Conventional Doppler echocardiographic measurements for left ventricular diastolic functions delineated the more frequent presence of diastolic dysfunction in cardiac syndrome X group As compared with controls (48% vs 18%; p<0.01). When both methods used for assessing diastolic dysfunction, it was found more apparent (66% vs 24%; p<0.01). When ROC curve was drawn for conventional Doppler echocardiography the AUC was 0.623, the sensitivity and the specificity were 49% and 76%, respectively. When the same was done for TDI the values were AUC=0.669, the sensitivity - 66% and the specificity - 68%.
Our study revealed the deterioration of left ventricular diastolic function in patients with cardiac syndrome X. We found TDI echocardiography was more sensitive to delineate left ventricular diastolic dysfunction in this category of patients when compared with conventional Doppler echocardiography.
本研究旨在比较组织多普勒成像（TDI）和传统多普勒超声心动图在诊断心脏综合征X患者左心室舒张功能障碍方面的诊断准确性。
本研究设计为横断面研究。在研究中，我们将35例心脏综合征X患者（19例女性，平均年龄47.2±7.3岁）与33名健康人作为对照组（18例女性，平均年龄49.5±7.1岁）进行比较，对照组无冠状动脉疾病，运动试验时无缺血性主诉或发现。通过考虑改良Simpson法测定左心室射血分数的平均值和TDI评估收缩波峰值速度来评估左心室收缩功能。用传统超声心动图和TDI评估左心室舒张功能。采用独立样本的非配对t检验或Mann-Whitney U检验比较连续变量，采用卡方检验比较分类变量。应用ROC曲线分析来确定传统多普勒超声心动图和组织多普勒成像预测舒张功能障碍的能力。
两组的左心室射血分数和收缩波峰值速度相似。与对照组相比，心脏综合征X组中左心室舒张功能的传统多普勒超声心动图测量显示舒张功能障碍更为常见（48%对18%；p<0.01）。当两种方法都用于评估舒张功能障碍时，发现其更为明显（66%对24%；p<0.01）。绘制传统多普勒超声心动图的ROC曲线时，AUC为0.623，敏感性和特异性分别为49%和76%。对TDI进行同样操作时，数值为AUC=0.669，敏感性为66%，特异性为68%。
我们的研究揭示了心脏综合征X患者左心室舒张功能的恶化。我们发现，与传统多普勒超声心动图相比，TDI超声心动图在这类患者中更能敏感地显示左心室舒张功能障碍。
