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Non -invasive assessment of left ventricular diastolic function: The impact of systole on diastole.

机译:左心室舒张功能的非侵入性评估:收缩期对舒张期的影响。

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摘要

Tissue Doppler imaging of the long axis motion of the heart and the flow propagation velocity are newer non-invasive methods based on Doppler echocardiography which have been developed recently for the assessment of left ventricular diastolic function. It is not clear if these techniques are superior in clinical practice over conventional methods which are based on the patterns of mitral inflow velocities, and whether they are affected by other factors such as age, gender, heart rate, and the degree of systolic function. Therefore, the aim of this study was to determine the usefulness of these indices compared to the standard methods to determine the main factors affecting these newer indices and whether they are able to predict prognosis in a variety of cardiovascular diseases. In addition the impact of systolic function on diastolic function measured by left ventricular long axis changes was evaluated.;518 normal subjects and patients with a variety of cardiovascular diseases were studied with full 2D Doppler echocardiographic studies including measurement of left ventricular long axis changes in systole and diastole by tissue Doppler imaging and atrio-ventricular plane displacement, propagation velocity, mitral inflow velocities, pulmonary venous velocities, ejection fraction and chamber dimensions by M-mode echocardiography.;Long axis systolic and early diastolic velocities and amplitudes decreased with aging, while the late diastolic (atrial) velocity and amplitude increased with aging. Both the velocity and amplitude in systole and in early diastole correlated with left ventricular ejection fraction and short axis fractional shortening even when corrected for age, heart rate and gender.;Tissue Doppler imaging is a very useful technique for assessing left ventricular long axis function and the early diastolic mitral annular velocity appears to be a particularly sensitive marker of mildly impaired function both diastolic and systolic. Furthermore, a close link between contraction and relaxation, especially during early diastole, was revealed. Early diastolic function is, therefore, very dependent on the previous systole. This study also found that even in those with an apparently 'normal' left ventricular ejection fraction ventricular long axis function is frequently impaired. In addition, the early diastolic long axis velocity is a strong independent predictor of cardiac mortality and it appears to be a very informative measurement. However, in contrast, the flow propagation velocity as measured by the standard method does not provide any more diagnostic value than the usual mitral Doppler inflow velocities. (Abstract shortened by UMI.).
机译:心脏长轴运动和血流传播速度的组织多普勒成像是基于多普勒超声心动图的较新的非侵入性方法,最近已开发出用于评估左心室舒张功能的方法。目前尚不清楚这些技术在临床实践中是否优于基于二尖瓣血流速度模式以及是否受年龄,性别,心律和收缩功能程度等其他因素影响的传统方法的传统方法。因此,本研究的目的是确定与标准方法相比,确定这些指标的有效性,以确定影响这些较新指标的主要因素,以及它们是否能够预测各种心血管疾病的预后。此外,还评估了收缩功能对通过左心室长轴变化测量的舒张功能的影响。;对518名正常受试者和患有各种心血管疾病的患者进行了全二维多普勒超声心动图研究,包括测量左心室长轴变化。组织多普勒成像和房室平面位移,传播速度,二尖瓣血流速度,肺静脉速度,射血分数和心室尺寸(通过M型超声心动图)对舒张期和舒张期;长轴收缩期和舒张早期期的速度和幅度随衰老而降低,而舒张末期(心房)的速度和幅度随衰老而增加。即使校正了年龄,心率和性别,收缩期和舒张早期的速度和幅度也与左心室射血分数和短轴分数缩短相关。组织多普勒成像是评估左心室长轴功能和舒张早期的二尖瓣环速度似乎是舒张和收缩功能轻度受损的特别敏感的标志。此外,揭示了收缩与放松之间的紧密联系,尤其是在舒张早期。因此,早期舒张功能很大程度上取决于先前的收缩期。这项研究还发现,即使在那些具有“正常”左心室射血分数的患者中,心室长轴功能也经常受到损害。另外,舒张早期的长轴速度是心脏死亡率的独立的强预测指标,它似乎是非常有用的测量方法。然而,相比之下,通过标准方法测得的流动传播速度没有提供比通常的二尖瓣多普勒血流速度更高的诊断价值。 (摘要由UMI缩短。)。

著录项

  • 作者

    Wang, Mei.;

  • 作者单位

    The Chinese University of Hong Kong (Hong Kong).;

  • 授予单位 The Chinese University of Hong Kong (Hong Kong).;
  • 学科 Health Sciences Medicine and Surgery.;Engineering Biomedical.
  • 学位 Ph.D.
  • 年度 2002
  • 页码 233 p.
  • 总页数 233
  • 原文格式 PDF
  • 正文语种 eng
  • 中图分类
  • 关键词

  • 入库时间 2022-08-17 11:46:34

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