组织多普勒成像评价正常成年人心室壁运动的同步性

Assessment of inter-and intraventricular synchrony by tissue Doppler echocardiography

目的探讨正常人心室壁机械运动同步性的变化规律。方法用组织多普勒速度-时间曲线技术,观察31例正常成年人左右心室与室间隔之间及其内部速度、加速度及达峰时间同步性。结果①在收缩期左心室与室间隔的速度峰值相近,而右心室的收缩速度高于左心室及室间隔,在舒张晚期室间隔与右心室的速度相近,但高于左心室;②左心室和室间隔在收缩期和快速充盈期的加速度峰值相近,大于右心室,右心室和室间隔的加速度峰值在舒张晚期相近,高于左心室;③心室壁和室间隔内速度和加速度的变化趋势为基底部>中部>心尖部;④收缩达峰时间和快速充盈达峰时间左心室和室间隔一致,右心室延迟;⑤基底部和中部在收缩期和舒张期速度达峰时间差小于20ms。结论心室壁的运动是同步的,但左右心室壁及心室内各个部位的运动不是同时的。

Objective To assess the synchrony of inter-and intraventricular in normal adults. Methods Tissue Doppler imaging(TDI) was performed in 31 normal subjects using apical four-chamber view and a three-basal, three middle, three apical-segmental model. The regional parameters were measured off line in both ventricles, including peak sustained systolic velocity (Vs) and acceleration, peak early diastolic velocity(Ve) and acceleration, peak late diastolic velocity(Va) and acceleration, as well as their time to these peak velocities: Ts, Te, and Ta. Results ① Vs of left ventricle (LV) and interventricular septum(IVS) had not difference, and was lower than that of right ventricle(RV). Va of RV and IVS had no difference, and was higher than that of LV. ② The acceleration in S of LV and IVS showed no difference, and was higher than that of RV. The acceleration in A of RV and IVS had no difference, and was higher than that of LV. ③ For regional velocities and accelerations, they were significantly higher in basal than mid-segments. And they were higher in middle than in apical-segments. ④ RV was about 60 ms later than the LV and IVS for Ts and about 20 ms for Te. ⑤ The difference of Ts and Te between basal and mid-segments had no significance, maybe less than 20 ms. Conclusions Systolic and diastolic functions of the normal hearts are highly synchronized, but LV and IVS contraction and slightly preceded that of RV.