多巴酚丁胺负荷超声心动图及组织多普勒成像技术在诊断冠心病中的临床应用

目的探讨多巴酚丁胺负荷超声心动图(DSE)和组织多普勒成像技术(TDI)在冠心病(CHD)诊断中的应用价值,以寻求一种敏感的、无创的CHD诊断方法。方法选择胸闷或胸痛怀疑CHD患者40例,应用TDI测量静息状态(Rest)下前壁中段收缩峰值速度(Vs),以及多巴酚丁胺峰值负荷状态(Peak)下前壁中段Vs,同时测量静息心率和负荷心率;所有入选对象均进行冠脉造影,并根据左前降支狭窄程度是否大于等于50%分为左前降支狭窄组(LST组)与左前降支非狭窄组(non-LST组)。分别比较Rest和Peak前壁中段LST组与non-LST组平均Vs差别等。结果Rest前壁中段LST组与non-LST组Vs差别无显著性意义;但Peak前壁中段LST组与non-LST组差别有显著性意义。结论DSE结合TDI是诊断冠心病有价值的定量分析方法。DSE在诊断CHD时的敏感性、准确性明显优于静息状态超声心动图。

Clinical application of dobutamine stress echocardiographic and tissue Doppler imaging in the diagnosis of coronary artery disease

Objective To assess the value of dobutamine stress echocardiography(DSE)and tissue Doppler imaging(TDI)in diagnosis of coronary heart disease(CHD).Methods The maximum myocardial systolic velocity(Vs)of MID ANT wall and MID INF wall were detected by TDI at rest status(Rest)and at peak stress status(Peak)in 40 patients with suspected CHD,at same time,heart rate were measured at Rest and Peak;All patients was performed coronary arteriography,and was divided into two groups(LST group and non-LST group)according to the results which whether descending anterior branch of left coronary artery was stenosis more than 50%;study was performed as following items:to compare Vs of MID ANT wall at Rest and Peak in the two groups of LST group and non-LST group,etc.Results There was significant difference in the Vs of MID ANT wall at Peak between LST group and non-LST group;on the other hand,there was no significant difference in the Vs of MID ANT wall at Rest between LST group and non-LST group.Conclusions The sensitivity and accuracy of diagnosing CHD by DSE was superior to that of Echo RS.Moreover,it is helpful for diagnosing CHD to combine the DSE with TDI.