CAJ | 학술논문

目的探讨彩色M型多普勒(CMM)评价二尖瓣置换术(MVR)后患者左室舒张功能的临床价值.方法 52例接受MVR术后3个月以上患者为病例组,另选取年龄、性别相匹配的30例正常人为对照组.测量左房室腔大小、机械瓣口流速、射血分数(EF)等常规超声心动图指标;应用CMM测量舒张期左室内彩色血流传播速度(Vp),计算二尖瓣位机械瓣口血流速度(E)与Vp比值(E/Vp);应用组织多普勒测量二尖瓣环舒张期峰值速度(Em),计算均值Em'和E/Em'.结果 ①MVR组Vp、Em较对照组明显减低,E/Vp、E/Em'较对照组明显增高,差异有统计学意义(P<0.001).E/Vp与E/Em'相关性良好,r=0.86,P <0.01;②Vp受左窜收缩功能和心律的影响,当EF≤50%或者心房颤动时,Vp减低更明显(P<0.01),而E/Vp受EF及心房颤动的影响较小(P>0.05);③绘制ROC曲线,以E/Vp≥2.00为最佳截断值,预测E/Em'≥15的敏感性为92.31%,特异性为83.65%,曲线下面积0.954.结论 CMM可用于评价MVR术后左室舒张功能;E/Vp与E/Em具有良好的一致性,可作为评价MVR术后左室舒张功能的有效指标.
목적 탐토채색M형다보륵(CMM)평개이첨판치환술(MVR)후환자좌실서장공능적림상개치.방법 52례접수MVR술후3개월이상환자위병례조,령선취년령、성별상필배적30례정상인위대조조.측량좌방실강대소、궤계판구류속、사혈분수(EF)등상규초성심동도지표;응용CMM측량서장기좌실내채색혈류전파속도(Vp),계산이첨판위궤계판구혈류속도(E)여Vp비치(E/Vp);응용조직다보륵측량이첨판배서장기봉치속도(Em),계산균치Em'화E/Em'.결과 ①MVR조Vp、Em교대조조명현감저,E/Vp、E/Em'교대조조명현증고,차이유통계학의의(P<0.001).E/Vp여E/Em'상관성량호,r=0.86,P <0.01;②Vp수좌찬수축공능화심률적영향,당EF≤50%혹자심방전동시,Vp감저경명현(P<0.01),이E/Vp수EF급심방전동적영향교소(P>0.05);③회제ROC곡선,이E/Vp≥2.00위최가절단치,예측E/Em'≥15적민감성위92.31%,특이성위83.65%,곡선하면적0.954.결론 CMM가용우평개MVR술후좌실서장공능;E/Vp여E/Em구유량호적일치성,가작위평개MVR술후좌실서장공능적유효지표.
Objective To evaluate the clinical value of color M-mode Doppler echocardiography (CMM) in assessing left ventricular(LV) diastolic function after mitral valve replacement(MVR). Methods Fifty-two patients who had received the implantation for more than three months were examined by echoeardiography (MVR group). Thirty age and sex-adjusted normal volunteers served as control group. Dimensions of left atrium and ventricle,ejection fraction(EF) and mitral inflow velocity(E) were measured by two-dimensional and Doppler eehocardiography. Color M-mode Doppler flow propagation velocity(Vp) and TDl-derived diastolic mitral annular velocity(Em) were measured from the apical four-chamber and two-chamber views. Then two new indexes based on the ratio of E to Vp(E/Vp) and E to Era' (E/Em') were while E/Vp and E/Era' increased, there were significant differences(P <0.01). The correlation coefficient and atrial fibrillation(P <20.01) ,however E/Vp was lower affected hy EF or atrial fibrillation(P >0.05). dysfunction were 2.00. Conclusions CMM is an effective technique to assess LV diastolic function after MVR. E/Vp has good consistency with E/Era and may be a potential useful parameter for assessing LV diastolic function.