|
Objective: Tissue Doppler imaging (tissue the Doppler imaging, TDI) technology and Tei index detection of coronary heart disease (coronary heart disease, CHD) diabetes (diabetes mellitus, DM) in patients with right ventricular systolic and diastolic function, to reveal coronary heart disease and diabetes of the right ventricular myocardium. Method: 1. Selected 51 cases of patients with coronary heart disease, 30 cases of patients with diabetes, 46 cases of coronary heart disease in patients with diabetes as one of three test group, and select outpatient health examination in 40 patients as a control group. Applications GE Vivid7 Dimension type ultrasonic diagnostic apparatus, conventional two-dimensional ultrasound echocardiography measuring left atrium inside diameter (LA), left ventricular end-diastolic diameter (LVED), right ventricular end diastolic diameter (RVED), left ventricular ejection fraction (LVEF), right atrial vertical diameter (RA1), right atrial transverse diameter (, RA2), mitral inflow E / A ratio (MV E / A). transferred to the TDI mode, measuring (1) tricuspid outer annulus and every annulus peak systolic movement speed (Sm), early diastolic peak velocity (Em) and late diastolic peak movement speed (Am), and calculate the Em / Am the average of representatives flap take two loci the overall speed of movement of the ring; (2) The right ventricular free wall and ventricular septal right ventricular side of the apex, middle and basal segment myocardial peak systolic movement speed (RVS), early diastolic peak velocity (RVE) and late diastolic peak velocity (3) measuring right ventricular isovolumic contraction (IVCT), ejection period (ET), etc. isovolumic relaxation (IVRT) and diastolic filling phase (DFT). calculate right ventricular systolic function index (RVSMPI (RVA); ) = IVCT / ET and right ventricular myocardial diastolic function index (RVDMPI) = IVRT / DFT. (4) the right heart Tei index = (IVCT IVRT) / ET. The above indicators are measured continuously three cardiac cycles, taking the mean. Results: the average body mass index of three test groups were significantly higher than that in the control group (from 26.01 ± 2.48,26.22 ± 1.55,26.32 ± 1.98 and 23.81 ± 2.21, respectively, p lt; 0.01) was no significant difference between the three experimental group (P gt; 0.05). 2 diabetes and coronary heart disease diabetes group triglycerides (triglyceride, TG) levels were significantly higher than the CHD group and the control group (2.94 ± 1.42,2.84 ± 1.23 and 1.61 ± 1.03,1.32 ± 0.70mmol/Lp lt; 0.05), coronary heart disease group and coronary heart disease diabetes group of low-density lipoprotein cholesterol (low density lipoprotein cholesterol, LDL-c) levels were significantly higher than the diabetic group and the control group (3.51 ± 1.56,3.86 ± 1.34 and 2.93 ± 0.97,2.67 ± 0.68 mmol / L, p lt; 0.05). The three test groups LA increased compared with the control group (p lt; 0.05), the MV the E / A compared with the control group decreased (p lt; 0.001). Measured in four groups the LVED, RVED, LVEF, RA1, RA2 differences were not statistically significant (p gt; 0.05). Three test groups tricuspid annulus overall, tricuspid septal annulus and tricuspid outside of annulus Em / Am than in the control group decreased (p lt; 0.05), the diabetic groups tricuspid lateral annulus elevated Am than coronary heart disease group and the control group (P lt; 0.001). Four groups tricuspid annulus overall, tricuspid septal annulus and tricuspid outside of annulus Sm were not statistically significant (P gt; 0.05). Apical segment of the three test groups right ventricular free wall and ventricular septal right ventricular side, middle and basal segments of the RVE reduce compared with the control group (P lt; 0.05), CHD group was the middle of the right ventricular free wall basal segments of the RVA than diabetes reduce and control groups (all p lt; 0.05). Four groups in the right ventricular free wall and septal right ventricular side RVS differences without statistical significance (P gt; 0.05). The IVRT extension of the three test groups compared with control group there, ejection time was shortened diastolic filling period was significantly shorter (both p lt; 0.01), right ventricular systolic function index increased (P lt; 0.05 ) and right ventricular diastolic function index was significantly higher (P lt; 0.01). Three test groups tricuspid septal leaflet Central, tricuspid lateral annulus and the annulus average measured value of Tei index was significantly higher than those in the control group (P lt; 0.01). Duration of diabetes and tricuspid ring Em / Am was negatively correlated (r = -0.636), p lt; 0.01. Conclusion: 1. Patients with coronary heart disease and diabetes have a higher body mass index and blood lipid levels, the former elevated LDL-c, the latter increased TG. Coronary heart disease, diabetes and patients with the two diseases coexist in left ventricular systolic function (EF) showed no significant difference left ventricular and right ventricular diastolic dysfunction, and right ventricular systolic function parameters (Sm) no significant changes. Suggesting that the two diseases or first manifested as ventricular diastolic function. Diabetes duration of disease may affect one of the factors of right ventricular diastolic function. 4. Coexistence of coronary heart disease and diabetes, compared with of pure coronary heart disease and simple diabetes, heart dysfunction no further aggravate confirmed by further studies still need to increase the sample size. Given the current lack of a \
|