心力衰竭患儿二尖瓣反流相关因素的超声心动图研究

目的：利用定量组织速度成像（QTVI）技术探讨心力衰竭（CHF）患儿左室非同步运动与二尖瓣反流的关系。方法：正常小儿40例,CHF患儿30例。（1）左心室非同步性指标检测获取标准心尖四腔和两腔观,QTVI状态下,获得左心室4个壁基底段、中间段和心尖段共12个位点的QTVI曲线,测量各位点QRS波起点至心肌收缩期峰值速度和舒张早期峰值速度的时限（Ts和Te）。计算左心室12个心肌节段Ts和Te的最大差值（Max-△Ts和Max-△Te）。（2）二尖瓣反流测量：于左室长轴切面,测量二尖瓣反流面积与左房面积比值MRA/LAA。结果：CHF组Max-△Ts和Max-△Te明显大于健康对照组;21例CHF患儿存在不同程度的二尖瓣反流;MRA/LAA与Max-△Te呈正相关（r=0.32,P〈0.05）,与Max-△Ts不相关（P〉0.05）。结论：CHF患儿存在的二尖瓣反流现象与左室非同步运动有关,其中舒张非同步运动对二尖瓣反流起主要作用。

Echocardiography Study on the Correlative Factors of Mitral Regurgitation in Children with Congestive Heart Failure

Objective：To study the correlation between left ventricular asynchronicity and mitral regurgitation in children with congestive heart failure by Quantitative tissue velocity imaging.Methods：40 normal children and 30 children with CHF were studied by QTVI.（1）The regional velocity profiles of 12 segments of left ventricle（LV）along LV apical four-chamber view and two-chamber view were obtained.The time from onset of QRS complexes to peak velocity during systole and early diastole（Ts and Te）were measured,The maximal difference in Ts and Te within all 12 segments（Max-Ts and Max-Te）of LV were calculated.（2）swell as to calculate the ratio of mitral regurgitation area to left atrium（MRA/LAA）.Results：Max-Ts and Max-Te in CHF group were significant prolonged compared with healthy group.Different Mitral regurgitation was exist in part of children with CHF.MRA /LAA was no related to Max-Ts and was positively related to Max-Te.Conclusion：It is correlated between left ventricular asynchronicity and mitral regurgitation in children with congestive heart failure,Diastolic asynchronicity is closely related to mitral regurgitation.