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目的 探索冠心病人左室等容舒张期和快速充盈期局部心肌的舒张运动特点及其临床意义。方法 以 6 0帧 /秒以上的高帧频对 18例心肌梗死病人 (MI组 )和 2 0例正常人 (对照组 )的左室心肌进行QTVI检查。获取左室各节段心肌长轴方向的同步运动曲线 ,测量其等容舒张期、快速充盈期、心房收缩期局部心肌的运动速度VIR、VE、VA,并测量二尖瓣口血流的快速充盈速度 (E)和左房收缩充盈速度 (A)及A/E比值。结果 对照组 17/ 2 0 (85 % )例、344 / 36 0 (95 .6 % )节段VIR≤ 2 .0cm/s,平均 - 0 .2 6± 1.13cm/s;MI组 2 / 18(11.1% )例、2 47/ 32 4(76 .2 % )节段VIR≤ 2 .0cm/s,平均 0 .0 4± 1.46cm/s。两组间VIR>2 .0cm/s例数的差别 (P <0 .0 0 1)和VIR值的差别 (P <0 .0 0 5 )都具有非常显著性的意义。局部节段心肌VIR极小加毗邻节段心肌VIR>2 .0cm/s ,对诊断局部舒张功能异常的敏感性 88.9% ,特异性 85 % ,准确性 86 .8% ,阳性预测值 84.2 %。A/E >1者 ,MI组 11/ 18(6 1.1% )例 ,多于对照组 7/ 2 0 (35 % )例 ,P <0 .0 5 ;但A/E与VIR无相关性。结论 QTVI能敏感、直观地无创定量评价局部心肌等容舒张功能异常 ,对诊断冠心病心肌等容缺血可能有重要价值
Objective To explore the characteristics and clinical significance of left ventricular LV diastolic and rapid diastolic regional myocardial relaxation in patients with coronary heart disease. Methods QTVI was performed on left ventricular myocardium of 18 patients with myocardial infarction (MI) and 20 normal controls (control group) at a high frame rate of 60 frames per second. The synchronized motion curve of the long axis of each segment of left ventricular was obtained and the VIR, VE, VA of the myocardium were measured at isovolumetric relaxation, rapid filling and atrial systole, and the mitral inflow velocity Filling speed (E) and left atrial contraction filling rate (A) and A / E ratio. Results The VIR≤2 .0cm / s and the average -0.26 ± 1.13cm / s in the control group were 17/20 (85%) and 344/36 (95.6% (11.1%) cases, 2 47/32 4 (76.2%) segments VIR≤2.0 cm / s with an average of 0.04 ± 1.46 cm / s. The difference of VIR> 2.0cm / s between the two groups (P <0.001) and the difference of VIR values (P <0.05) all had very significant significance. The VIR> 2. 0cm / s in the segmental myocardium with minimal VIR plus adjacent segment myocardium was 88.9%, specificity 85%, accuracy 86.8%, and positive predictive value 84.2% in diagnosing local diastolic dysfunction. A / E> 1, 11/18 (61.1%) cases in MI group were more than 7/20 (35%) cases in control group, P <0.05. There was no correlation between A / E and VIR. Conclusion QTVI can sensitively and intuitively non-invasive quantitative assessment of regional myocardial isometric relaxation abnormalities, myocardial ischemia diagnosis of coronary heart disease may have important value