CAJ | 학술논문

目的应用心肌速度分布图(MVP)测定心肌运动速度,计算心肌速度阶差(MVG),评价无临床并发症糖尿病患者左心室功能.方法无并发症2型糖尿病患者30例,对照组30例.常规超声心动图检测左室结构及二尖瓣血流E/A、左室射血分数(LVEF)、左室短轴缩短率(LVFS),并计算左室质量指数(LVMI);采用多普勒组织成像(DTI)测量二尖瓣环长轴方向收缩期峰值运动速度(Sm)、舒张早期运动速度(Em)与舒张晚期运动速度(Am);应用MVP测量左室后壁心外膜和心内膜下心肌运动速度,计算收缩期和舒张期心肌速度阶差(MVGs、MVGd).结果与对照组比较,糖尿病组左房、左室增大,室间隔增厚,LVMI增加(P<0.05或P<0.01),MVGs、MVGd、Em减低(P<0.05或P<0.01);E/A、E/Era、Em/Am、Sm、LVEF、LVFS在两组间差异无统计学意义.结论糖尿病患者在I临床并发症出现前已发生心脏结构及功能的改变;通过MVP获取心肌运动速度计算的MVG是评价左室心肌功能准确而敏感的指标.
목적 응용심기속도분포도(MVP)측정심기운동속도,계산심기속도계차(MVG),평개무림상병발증당뇨병환자좌심실공능.방법 무병발증2형당뇨병환자30례,대조조30례.상규초성심동도검측좌실결구급이첨판혈류E/A、좌실사혈분수(LVEF)、좌실단축축단솔(LVFS),병계산좌실질량지수(LVMI);채용다보륵조직성상(DTI)측량이첨판배장축방향수축기봉치운동속도(Sm)、서장조기운동속도(Em)여서장만기운동속도(Am);응용MVP측량좌실후벽심외막화심내막하심기운동속도,계산수축기화서장기심기속도계차(MVGs、MVGd).결과 여대조조비교,당뇨병조좌방、좌실증대,실간격증후,LVMI증가(P<0.05혹P<0.01),MVGs、MVGd、Em감저(P<0.05혹P<0.01);E/A、E/Era、Em/Am、Sm、LVEF、LVFS재량조간차이무통계학의의.결론 당뇨병환자재I림상병발증출현전이발생심장결구급공능적개변;통과MVP획취심기운동속도계산적MVG시평개좌실심기공능준학이민감적지표.
Objective To evaluate the structure and function of left ventricle in diabetes mellitus (DM) patients without complications by myocardial velocity gradient (MVG) measured by myocardial velocity profile (MVP). Methods Thirty type 2 DM patients without complications and 30 healthy volunteers as controls were enrolled. The heart structure, systolic function and diastolic function of left ventricle were measured by echocardiography and the left ventricular mass index (LVMI) was calculated. Mitral annular systolic movement (Sm) , early rapid filling phase movement ( Em) and atrial contraction movement(Am) were measured by tissue Doppler image and the left ventricular MVG at diastole and systole in subendocardium and subepicardium (MVGs,MVGd) were measured by MVP. Results The diameter of left atria and left ventricle, thickness of interventricular septum and LVMI were higher in DM group than those of control group ( P <0. 05 or P <0. 01) , MVGs, MVGd, and Em were lower in DM group than those of control group( P <0. 05 or P <0. 01). There were no significant differences on E/A, Em/Am and E/Em between two groups. In addition, there were also no significant differences on Sm,left ventricular ejection fraction and left ventricular fraction shortening between two groups. Conclusions Structure and function of left ventricle have changed in patients of DM without complications. MVG measured by MVP is an accurate and sensitive index to assess left ventricular systolic and diastolic function.