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目的探讨心力衰竭患儿二尖瓣环运动速度的变化及其在左心室功能评价中的应用价值。方法研究对象为2005-01—2006-05在北京大学第一医院儿科住院的21例左室扩大及左室射血分数<50%的心力衰竭患儿(心衰组)和21例正常儿童(对照组),对其行常规超声心动图检查,测量左室射血分数(LVEF)、二尖瓣口前向血流E峰和A峰的峰值流速,计算E/A值;以组织多普勒成像(TDI)脉冲多普勒速度频谱显像方法测量二尖瓣环侧壁及间壁收缩期峰值速度(Sa)、舒张早期峰值速度(Ea)及舒张晚期峰值速度(Aa),分别计算Ea/Aa值及E/Ea值。结果心衰组二尖瓣环侧壁及间壁Sa、Ea、Ea/Aa均显著低于对照组(P均<0.01),两部位E/Ea均显著高于对照组(P均<0.01);心衰组二尖瓣环两部位Sa、侧壁Ea均与LVEF正相关((r=0.60,0.44,0.52,P均<0.05),两部位Sa、Ea均与心功能分级负相关(r=-0.64,-0.55,-0.68,-0.54,P均<0.05),两部位E/Ea均与LVEF负相关(r=-0.59,-0.47,P均<0.05)、与心功能分级正相关(r=0.77,0.75,P均<0.001)、二尖瓣环侧壁及间壁Sa与相应部位Ea、E/Ea有相关性。结论常规超声检查左室收缩功能下降的心力衰竭患儿左室收缩及舒张功能均降低,且二者有密切联系;以TDI方法测定二尖瓣环运动频谱评价心力衰竭儿童左室功能是敏感和可靠的。
Objective To investigate the changes of mitral annulus velocity in children with heart failure and its value in the evaluation of left ventricular function. Methods Twenty-one children with heart failure (heart failure group) and 21 normal children (HF group) with left ventricular enlargement and LV ejection fraction <50% were enrolled in pediatric department of Peking University First Hospital from January 2005 to June 2005. Control group), routine echocardiography was performed to measure the left ventricular ejection fraction (LVEF), mitral valve anterior peak blood flow E peak and peak A peak flow rate, calculate the E / A value; The peak systolic velocity (Sa), early diastolic velocity (Ea) and late diastolic velocity (Aa) of the mitral annular wall and the mitral wall were measured by TDI pulsed Doppler velocity spectral imaging. Ea / Aa value and E / Ea value. Results Sa, Ea and Ea / Aa in mitral valve annulus were significantly lower than those in control group (all P <0.01), and E / Ea in both groups were significantly higher than those in control group (all P <0.01). There was a positive correlation between Sa and Ea and LVEF (r = 0.60, 0.44, 0.52, P <0.05) in both groups, and both Sa and Ea were negatively correlated with cardiac function classification (r = (P <0.05). There was a negative correlation between E / Ea and LVEF (r = -0.59, -0.47, P <0.05) r = 0.77,0.75, P <0.001). There was a correlation between Ea, E / Ea and Ea and E / Ea in mitral annular wall and interlobular wall.Conclusion Conventional sonography can detect left ventricular systolic function in children with heart failure with decreased left ventricular systolic function And diastolic function are reduced, and the two are closely linked; using the TDI method to measure mitral annular motion spectrum evaluation of left ventricular function in children with heart failure is sensitive and reliable.