R指数评价静息状态下动力型左室腔流出梗阻的价值及其临床意义
发布时间：2018-12-06 18:46
【摘要】：目的:通过常规超声心动图总结静息状态下动力型左室腔流出梗阻(DIVO)心动图特征,并根据其特点设计一个新的指标R指数(狭窄处等容舒张期流速/左室主动舒张峰速度),探讨R指数定量评价DIVO的价值。方法:选取以胸痛、胸闷就诊的DIVD患者112例(梗阻组),同时选取50名健康者作为健康对照组。采用常规二维超声心动图获取研究对象左室收缩末径(LVESD)、左室舒张末径(LVEDD)、间隔上部厚度(U-IVS)、中部厚度(M-IVS)和左室射血分数(LVEF)。彩色多普勒超声获取左室腔流速(流出道流速、左室中部流速和左室心尖部流速)。在心脏各切面观察左室心肌运动和左室腔内彩色血流,并测量收缩末期左室腔最窄处内径,于血流汇聚处获取平静呼吸及Valsalva试验下的等容舒张峰峰速、左室主动舒张峰E峰峰速及R指数,绘制受试者工作特征曲线(ROC),计算曲线下面积(AUC),根据约登指数确定R指数的诊断界点。结果:与健康对照组比较,梗阻组患者心率偏快,血压偏高(P0.01)。梗阻组患者二维超声心动图特征表现为左室心肌运动活跃,心腔相对偏小,且可见几何形变;DIVO患者左室腔内正常流速梯度趋势发生改变,收缩期血流频谱呈峰值后移,于等容舒张期可见等容舒张峰,且等容舒张峰速明显快于健康对照组(P0.01),R指数明显大于健康对照组(P0.01)。结论:DIVO患者R指数明显增大,且R指数≥1可作为静息状态下DIVO患者特异性诊断指标。
[Abstract]:Objective: to summarize the (DIVO) cardiogram features of dynamic left ventricular outflow obstruction in resting state by conventional echocardiography. A new index R index (isovolumic diastolic velocity / left ventricular active diastolic peak velocity) was designed according to its characteristics, and the value of R index in quantitative evaluation of DIVO was discussed. Methods: 112 DIVD patients with chest pain and chest tightness were selected (obstruction group) and 50 healthy persons were selected as healthy control group. Left ventricular end-systolic diameter (LVESD), left ventricular end-diastolic diameter (LVEDD), upper septal thickness (U-IVS), middle thickness (M-IVS) and left ventricular ejection fraction (LVEF).) were obtained by conventional two-dimensional echocardiography. The flow velocity of left ventricular cavity (outflow tract velocity, left ventricular middle velocity and left ventricular apical velocity) was measured by color Doppler ultrasound. Left ventricular motion and color blood flow in left ventricular lumen were observed on each side of the heart. The narrowest diameter of left ventricular cavity at the end of contraction was measured, and the isovolumetric diastolic peak velocities were obtained at the convergent point of blood flow, and the isovolumic diastolic peak velocities were obtained by Valsalva test. The E peak velocity and R index of the left ventricular active diastolic peak were drawn. The area under the curve was calculated by (ROC),. The diagnostic threshold point of R index was determined according to Jorden index. Results: compared with the healthy control group, the heart rate and blood pressure in the obstruction group were higher than those in the control group (P 0.01). In the obstruction group, the characteristics of two-dimensional echocardiography showed that the left ventricular myocardium was active, the cardiac cavity was relatively small, and geometric deformation was observed. The trend of normal flow velocity gradient in left ventricular lumen of DIVO patients was changed, the peak value of systolic blood flow was shifted backward, isovolumic diastolic peak was observed in isovolumic diastolic phase, and the peak velocity of isovolumic diastolic peak was significantly faster than that of healthy control group (P0.01). The R index was significantly higher than that in the healthy control group (P0.01). Conclusion: the R index of DIVO patients was significantly increased, and R index 鈮，
本文编号：2366485
[Abstract]:Objective: to summarize the (DIVO) cardiogram features of dynamic left ventricular outflow obstruction in resting state by conventional echocardiography. A new index R index (isovolumic diastolic velocity / left ventricular active diastolic peak velocity) was designed according to its characteristics, and the value of R index in quantitative evaluation of DIVO was discussed. Methods: 112 DIVD patients with chest pain and chest tightness were selected (obstruction group) and 50 healthy persons were selected as healthy control group. Left ventricular end-systolic diameter (LVESD), left ventricular end-diastolic diameter (LVEDD), upper septal thickness (U-IVS), middle thickness (M-IVS) and left ventricular ejection fraction (LVEF).) were obtained by conventional two-dimensional echocardiography. The flow velocity of left ventricular cavity (outflow tract velocity, left ventricular middle velocity and left ventricular apical velocity) was measured by color Doppler ultrasound. Left ventricular motion and color blood flow in left ventricular lumen were observed on each side of the heart. The narrowest diameter of left ventricular cavity at the end of contraction was measured, and the isovolumetric diastolic peak velocities were obtained at the convergent point of blood flow, and the isovolumic diastolic peak velocities were obtained by Valsalva test. The E peak velocity and R index of the left ventricular active diastolic peak were drawn. The area under the curve was calculated by (ROC),. The diagnostic threshold point of R index was determined according to Jorden index. Results: compared with the healthy control group, the heart rate and blood pressure in the obstruction group were higher than those in the control group (P 0.01). In the obstruction group, the characteristics of two-dimensional echocardiography showed that the left ventricular myocardium was active, the cardiac cavity was relatively small, and geometric deformation was observed. The trend of normal flow velocity gradient in left ventricular lumen of DIVO patients was changed, the peak value of systolic blood flow was shifted backward, isovolumic diastolic peak was observed in isovolumic diastolic phase, and the peak velocity of isovolumic diastolic peak was significantly faster than that of healthy control group (P0.01). The R index was significantly higher than that in the healthy control group (P0.01). Conclusion: the R index of DIVO patients was significantly increased, and R index 鈮，
本文编号：2366485
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