【摘要】：目的:通過常規(guī)超聲心動圖總結靜息狀態(tài)下動力型左室腔流出梗阻(DIVO)心動圖特征,并根據(jù)其特點設計一個新的指標R指數(shù)(狹窄處等容舒張期流速/左室主動舒張峰速度),探討R指數(shù)定量評價DIVO的價值。方法:選取以胸痛、胸悶就診的DIVD患者112例(梗阻組),同時選取50名健康者作為健康對照組。采用常規(guī)二維超聲心動圖獲取研究對象左室收縮末徑(LVESD)、左室舒張末徑(LVEDD)、間隔上部厚度(U-IVS)、中部厚度(M-IVS)和左室射血分數(shù)(LVEF)。彩色多普勒超聲獲取左室腔流速(流出道流速、左室中部流速和左室心尖部流速)。在心臟各切面觀察左室心肌運動和左室腔內彩色血流,并測量收縮末期左室腔最窄處內徑,于血流匯聚處獲取平靜呼吸及Valsalva試驗下的等容舒張峰峰速、左室主動舒張峰E峰峰速及R指數(shù),繪制受試者工作特征曲線(ROC),計算曲線下面積(AUC),根據(jù)約登指數(shù)確定R指數(shù)的診斷界點。結果:與健康對照組比較,梗阻組患者心率偏快,血壓偏高(P0.01)。梗阻組患者二維超聲心動圖特征表現(xiàn)為左室心肌運動活躍,心腔相對偏小,且可見幾何形變;DIVO患者左室腔內正常流速梯度趨勢發(fā)生改變,收縮期血流頻譜呈峰值后移,于等容舒張期可見等容舒張峰,且等容舒張峰速明顯快于健康對照組(P0.01),R指數(shù)明顯大于健康對照組(P0.01)。結論:DIVO患者R指數(shù)明顯增大,且R指數(shù)≥1可作為靜息狀態(tài)下DIVO患者特異性診斷指標。
[Abstract]:Objective: to summarize the (DIVO) cardiogram features of dynamic left ventricular outflow obstruction in resting state by conventional echocardiography. A new index R index (isovolumic diastolic velocity / left ventricular active diastolic peak velocity) was designed according to its characteristics, and the value of R index in quantitative evaluation of DIVO was discussed. Methods: 112 DIVD patients with chest pain and chest tightness were selected (obstruction group) and 50 healthy persons were selected as healthy control group. Left ventricular end-systolic diameter (LVESD), left ventricular end-diastolic diameter (LVEDD), upper septal thickness (U-IVS), middle thickness (M-IVS) and left ventricular ejection fraction (LVEF).) were obtained by conventional two-dimensional echocardiography. The flow velocity of left ventricular cavity (outflow tract velocity, left ventricular middle velocity and left ventricular apical velocity) was measured by color Doppler ultrasound. Left ventricular motion and color blood flow in left ventricular lumen were observed on each side of the heart. The narrowest diameter of left ventricular cavity at the end of contraction was measured, and the isovolumetric diastolic peak velocities were obtained at the convergent point of blood flow, and the isovolumic diastolic peak velocities were obtained by Valsalva test. The E peak velocity and R index of the left ventricular active diastolic peak were drawn. The area under the curve was calculated by (ROC),. The diagnostic threshold point of R index was determined according to Jorden index. Results: compared with the healthy control group, the heart rate and blood pressure in the obstruction group were higher than those in the control group (P 0.01). In the obstruction group, the characteristics of two-dimensional echocardiography showed that the left ventricular myocardium was active, the cardiac cavity was relatively small, and geometric deformation was observed. The trend of normal flow velocity gradient in left ventricular lumen of DIVO patients was changed, the peak value of systolic blood flow was shifted backward, isovolumic diastolic peak was observed in isovolumic diastolic phase, and the peak velocity of isovolumic diastolic peak was significantly faster than that of healthy control group (P0.01). The R index was significantly higher than that in the healthy control group (P0.01). Conclusion: the R index of DIVO patients was significantly increased, and R index 鈮，

本文編號：2366485