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目的评价组织多普勒显像(TDI)检测左右心室长轴方向收缩功能对扩张型心肌病(DCM)患者运动耐量的预测价值。方法对65例DCM患者进行心肺功能测定和TDI检查。根据运动试验测定的最大耗氧量(VO2max)分为两组:A组VO2max<14 ml.kg-1.min-1共29例,B组VO2max≥14 ml.kg-1.min-1共36例。用TDI方式于心尖四腔观分别检测两组患者左室侧壁(L)、室间隔(S)和右室侧壁(R)的瓣环处(1)、乳头肌水平(3)和二者中点(2)的射血前期心肌运动速度(is)和射血期心肌运动速度(ez),结果进行组间比较,并与VO2max进行相关性分析。结果TDI检测的A组的R3ez、S1ez、L1ez、L1is、L2is、L3is均低于B组(P<0.05),并且对预测VO2max减低有较高的敏感性和特异性。结论TDI检测左右心室收缩速度预测扩张型心肌病的运动耐量简便并有较高的准确性。
Objective To evaluate the value of tissue Doppler imaging (TDI) in predicting exercise tolerance in patients with dilated cardiomyopathy (DCM) by measuring systolic function in the long axis of left and right ventricles. Methods Sixty-five DCM patients were tested for cardiopulmonary function and TDI. The maximum oxygen consumption (VO2max) was determined according to exercise test divided into two groups: A group VO2max <14 ml.kg-1.min-1 in 29 cases, B group VO2max ≥ 14 ml.kg-1.min-1 36 cases. The TDI (1), the papillary muscle level (3) and the papillary muscle (2) were detected by TDI in apical four-chamber view in the left ventricular wall (L), ventricular septum (S) and right ventricular wall (2), the myocardial ejection velocity (is) and the ejection velocity (ez) were measured. The results were compared between groups and the correlations were analyzed with VO2max. Results The results of TDI showed that R3ez, S1ez, L1ez, L1is, L2is and L3is in group A were lower than those in group B (P <0.05), and were higher sensitivity and specificity in predicting the decrease of VO2max. Conclusions The TDI test of left and right ventricular contraction velocity predicts the exercise tolerance of dilated cardiomyopathy is simple and has high accuracy.