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目的探讨定量组织速度成像(QTVI)技术对心功能的评价作用及其在诊断左心哀竭中的价值。方法对30例左心衰竭患者及32例止常人行常规超声心动图检查,以简化双平面Simpson 法计算出左室射血分数(LVEF);使用 QTVI 技术,测量左室壁二尖瓣环6个位点的收缩期峰值速度(Vs)、收缩期最大位移(Ds)。比较心衰组与正常对照组、心哀组治疗前与治疗后的二尖瓣环6个位点平均 Vs、平均 Ds,并将平均 Vs、平均 Ds 与 INEF 做相关性分析,探讨 QTVI 技术对心功能的评价作用及其对左室收缩性心力衰竭的诊断价值。结果二尖瓣环6个位点平均 Vs,心衰组明显低于正常对照组[(2.8±0.6)cm/s vs(6.4±0.9)cm/s,P<0.01],心衰组治疗后比治疗前显著升高[(3.5±1.1)cm/s vs(2.8±0.6)cm/s,P<0.01];二尖瓣环6个位点平均 Ds,心衰组显著低于正常对照组[(5.2±1.5)mm vs(11.6±1.5)mm,P<0.01],心衰组治疗后比治疗前显著升高[(6.5±2.0)mm vs(5.2±1.5)mm,P<0.01]。二尖瓣环6个位点平均 Vs、平均 Ds 与 LVEF 呈显著正相关(r 分别为0.87,0.89,均 P<0.01)。左室壁二尖瓣环6个位点平均 Vs 在诊断左心衰竭的受试者工作特征曲线下面积为0.95。以4.42 cm/s 为界值,二尖瓣环6个位点平均 Vs 诊断左心衰竭的敏感性为97.5%,特异性为90.2%,准确度为95.1%。左室壁二尖瓣环6个位点平均收缩期最大位移Ds 在诊断左心衰竭的受试者工作特征曲线下面积为0.96。以8.49 mm 为界值,二尖瓣环6个位点平均Ds 诊断左心衰竭的敏感性为97.5%,特异性为87.8%,准确度为95.1%。结论 QTVI 技术测定的二尖瓣环6个位点的平均 Vs、平均 Ds 可以评价左心室收缩功能,对左心衰竭有重要的诊断价值。
Objective To investigate the evaluation of cardiac function by quantitative tissue velocity imaging (QTVI) and its value in the diagnosis of left heart failure. Methods Thirty patients with left ventricular failure and 32 normal subjects were examined by conventional echocardiography, and the left ventricular ejection fraction (LVEF) was calculated by the simplified biplane Simpson method. The left ventricular wall mitral annulus 6 Systolic peak velocity (Vs), systolic peak displacement (Ds) at each site. The average Vs, average Ds of 6 sites of mitral annulus before and after treatment were compared between HF group and normal control group, and the average Vs, average Ds and INEF were analyzed to explore the relationship between QTVI Evaluation of Cardiac Function and Its Diagnostic Value in Left Ventricular Systolic Heart Failure. Results The mean Vs of 6 mitral annulus rings were significantly lower in heart failure group than in normal control group [(2.8 ± 0.6) cm / s vs (6.4 ± 0.9) cm / s, P <0.01] (3.5 ± 1.1) cm / s vs (2.8 ± 0.6) cm / s, P <0.01]. The average Ds of 6 mitral annulus was significantly lower than those of the normal control group (5.2 ± 1.5) mm vs (11.6 ± 1.5) mm, P <0.01]. The heart failure group was significantly higher than that before treatment [(6.5 ± 2.0) mm vs (5.2 ± 1.5) mm, P <0.01] . The average Vs of 6 sites of mitral annulus and average Ds were positively correlated with LVEF (r = 0.87,0.89, all P <0.01). The mean Vs at the six sites of the left ventricular wall mitral annulus was 0.95 under the receiver operating characteristic curve for diagnosing left ventricular failure. With a cutoff value of 4.42 cm / s, the average Vs of 6 mitral annulus was 97.5%, the specificity was 90.2% and the accuracy was 95.1%. Left ventricular mitral annular 6 sites average systolic maximum displacement Ds in the diagnosis of left heart failure in subjects under the operating characteristic curve area of 0.96. With 8.49 mm as a cutoff, the average Ds of 6 mitral annulus was 97.5%, the specificity was 87.8% and the accuracy was 95.1%. Conclusion The average Vs and average Ds of 6 mitral annulus measured by QTVI technique can evaluate left ventricular systolic function and have important diagnostic value for left ventricular failure.