摘要目的 应用定量组织组织多普勒技术结合左室球形指数评价二尖瓣关闭不全(MI)左室几何形态学变化与左室局部心肌节段功能的变化.方法 应用彩色多普勒及组织多普勒技术(QTVI)测量62例MI患者及30例正常人左心室几何形态学及其左室整体和局部心功能指标,以左心室射血分数(LVEF)作为左室整体收缩功能的指标,以肺静脉D峰速度(PVd)与a峰速度(PVa)比值PVd/PVa为左室整体舒张功能的指标;以不同室壁中间部心肌运动收缩期峰值速度(Vs)、收缩期加速度(a)、快速充盈期和心房收缩期的速度(Ve和Va)作为左室局部收缩舒张功能的指标;以左室球形指数(SI)即左室长径/短径比值(L/D)包括以左室收缩末球形指数(SIs)及舒张末球形指数(SId)作为反映左心室几何构型变化的指标,比较MI患者及正常人上述各参数差异,并分析各参数的相关关系.结果 MI患者Ve、Va、a、Vs、PVd/PVa比值、SIs、SId较正常人低;a与SIs呈正相关(r=0.602,P<0.05),Ve/Va与SId呈正相关(r=0.635,P<0.05).结论 MI左室几何形态学变化与其心功能相关,左心功能越好,左室球形化程度越轻.

abstractsObjective To evaluate the left ventricle geometry shape and left heart regional function in mitral insufficiency (MI) by quantitative tissue velocity imaging (QTVI) and the left ventricle systolic and diastolic geometry spbericity index. Methods Thirty normal subjects and 62 MI patients underwent QTVI and color Doppler imaging (CDFI) were enrolled in this study in order to measure the left ven-tricular geometry shape and left ventrieular regional function along LV apical long-axis view. Off-line LV regional velocity images along LV apical long-axis view were synchronously obtained. Peak tissue velocities of LV regional muscular tissue during systole(Vs),systolic acceler-ation(a), early diastole(Ve), LA contraction(Va)were synchronously measured as the index of left ventricular regional systolic and dias-tolic function. The left ventricle geometry shape index were reflected from the systolic and diastolic geometry sphericity index (SIs and Sid) and the left ventrieular ejection fraction (LVEF) and the peak D and peak a (PVd/PVa) of pulmonary veins flowing spectrum reflected the global left ventricular function index. The Vs, Ve, Va, a, PVd/PVd ratio, LVEF, SIs, SId were recorded and their correlation between normal subjects and patients with MI were compared. Result Vs, Ve,Va,a,PVd/ PVa ratio,SIs,SId in patients with MI were significantly re-duced. There was positive relation between Sis and a(r=0.602)and Ve/Va and SId(r=0.635). Conclusion There was negative rela-tion between regional cardiac function and LV spberieity, the higher cardiac function was accompanied with the lower SI.