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目的探讨左心房容积指数(LAVI)联合组织多普勒评价食管癌患者放疗后左心功能早期损伤的价值。方法对40例首次接受胸部放疗的食管癌患者,于放疗前、放疗后进行超声心动图检查,记录常规超声参数、组织多普勒参数及LAVI,并进行统计学分析,分析LAVI与舒张早期二尖瓣血流速度(E)/二尖瓣环舒张早期峰值速度(Em)的相关性。结果与放疗前相比,常规超声指标放疗前后无明显变化(P均>0.05);放疗后二尖瓣环舒张期峰值速度(Sm)、Em、Em/二尖瓣环舒张晚期峰值速度(Am)降低,Am和E/Em升高,LAVI放疗后亦升高,且LAVI与E/Em呈正相关(r=0.87,P<0.001)。结论食管癌患者接受放疗后,早期放射性心脏损伤主要表现为心脏舒张功能减退,组织多普勒、E/Em、LAVI可作为早期左心功能损伤的较好指标。
Objective To investigate the value of left atrial volume index (LAVI) combined with tissue Doppler imaging in early diagnosis of left ventricular dysfunction in patients with esophageal cancer after radiotherapy. Methods Forty patients with esophageal cancer who underwent thoracic radiotherapy for the first time were examined by echocardiography before radiotherapy and after radiotherapy. Conventional ultrasound parameters, tissue Doppler parameters and LAVI were recorded and statistically analyzed. The relationship between LAVI and early diastolic Correlation of aortic valve velocity (E) / mitral annulus early peak velocity (Em). Results Compared with those before radiotherapy, the conventional ultrasound did not change significantly before and after radiotherapy (all P> 0.05). After radiotherapy, peak diastolic velocity (Sm), Em, Em / peak diastolic mitral annular velocity (Am ) Decreased, Am and E / Em increased, LAVI increased after radiotherapy, and LAVI was positively correlated with E / Em (r = 0.87, P <0.001). Conclusions Radiographic cardiomyopathy in patients with esophageal cancer, early radiation heart damage mainly manifested as diastolic dysfunction, tissue Doppler, E / Em, LAVI can be used as a good indicator of early left cardiac dysfunction.