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目的探讨应用组织多普勒(TDI)评价不同冠状动脉狭窄患者心房内及心房间同步性的临床价值。方法左回旋支狭窄患者17例(LCX组)、右冠状动脉狭窄患者31例(RCA组)及冠状动脉造影狭窄率<30%的患者30例(对照组)。TDI条件下将取样容积依次放在心尖四腔观二尖瓣环左房侧壁、房间隔及三尖瓣环右房侧壁。测量三个部位从心电图P波起点到TDI频谱图A波起点的时间P-A值。并计算左、右心房内及两心房间机械延迟时间(T_(LA)、T_(RA)、T_(L-R))。结果与对照组相比,LCX组左心房内、两心房间电机械活动存在不同步,RCA组右心房内、两心房间电机械活动存在不同步。结论不同冠状动脉狭窄患者心房内和心房间的同步性改变存在差异。TDI可准确评价冠状动脉狭窄患者心房电机械活动的同步性。
Objective To evaluate the clinical value of tissue Doppler (TDI) in the evaluation of atrial and cardiac atrial synchrony in patients with different coronary artery stenosis. Methods Twenty-seven patients (LCX group), 31 patients with right coronary artery stenosis (RCA group), and 30 patients with coronary angiography stenosis rate <30% (control group). TDI under the conditions of the sampling volume on the apical four chamber view of mitral annulus atrial wall, atrial septal and tricuspid ring right atrial wall. The time P-A values of three sites from the beginning of the P wave of the electrocardiogram to the beginning of the A wave of the TDI spectrogram were measured. The mechanical delay time (T_ (LA), T_ (RA), T_ (L_R)) in the left and right atria and both hearts were calculated. Results Compared with the control group, the mechanical activities of the left atrium and the left atrium in LCX group were asynchronous. The mechanical activities in the right atrium and the left atrium of RCA group were not synchronized. Conclusion There are differences between the atrial and atrial systolic changes in patients with different coronary artery stenosis. TDI can accurately assess the synchronization of atrial electromechanical activity in patients with coronary artery stenosis.