用组织多谱勒评价正常人左右心室壁的速度和加速度

Myocardial wall velocity and acceleration assessment by velocity Tissue Doppler Imaging: Characteristic findings in normal subjects

目的:心脏多部位组织多普勒速度曲线同时显示技术是目前研究心室功能的新技术。方法:本研究运用组织多普勒技术,对31例正常人,在心尖四腔切面,在同一心动周期同时对心室及室间隔的9个观察点的心肌运动速度、加速度进行观察。结果:基底部的速度大于心室中部,中部大于心尖部。最快的速度出现于左心室舒张早期(10.36±3.54)cm／s,右心室的运动速度在等容收缩期、收缩期及舒张晚期均大于左心室。在收缩期和舒张早期,左右心室的速度达峰时间不同,左心室和室间隔在前,右心室在后。左心室在射血期和舒张早期加速度较右心室大,右心室在等容收缩期和舒张晚期的加速度较左室大,舒张早期左心室和室间隔的加速度大于右心室,舒张晚期是右心室和室间隔的加速度大于左心室。结论:组织多普勒是评价心室运动功能准确可靠的方法。

Objective: The normal features of TDI of the adult heart have already been described by many authors. Most of them sought to determine the left ventricular myocardial velocities using pulsed Tissue Doppler Imaging. To validate the use of velocity Tissue Doppler Imaging that measures myocardial wall velocities and acceleration and to define the characteristics of these velocities and accelerations in normal subjects, we obtained and compared the right and left ventricular wall velocities and accelerations in 31 volunteers. Methods: From apical four -chamber view, peak velocities and accelerations were measured within the basal, mid and apical parts of the interventricu-lar septum, and the left and right free ventricular wall in same heart cycle. Results: The highest peak velocities were obtained within the basal parts of all myocardial walls. The peak velocities within mid parts were higher than it within apical parts. Right ventricular wall velocities were higher than left ventricular wall during systole (isovolumic contraction, IVC, and ejection period, (Sa) and late diastolic (Aa). In systolic and early diastolic phases, left ventricular and interventricular septum moved before the right ventricular. The highest accelerations of ventricular motion occurred at isovolumix contraction within right ventricular basal parts (1.76± 1.46 cm/s2). In early diastolic, the accelerations of left ventricular and interventricular septum were higher than it of right ventricular. During late diastolic period, the accelerations of right ventricular and interventricular septum were higher than it of left ventricular. Conclusion: Velocity Tissue Doppler Imaging is useful and accurate method to assess ventricular wall motion and functions.