颈动脉血流速度作为心肌收缩力的一种测量指标。

Blood flow velocity in the carotid artery as a measure of myocardial contractility.

作者信息

Ishikawa K, Buggs H, Sarma R, Tillmanns H, Fauvel J M, Getzen J H, Johnson J L, Bing R J

出版信息

Jpn Heart J. 1975 Jan;16(1):22-35. doi: 10.1536/ihj.16.22.

DOI:10.1536/ihj.16.22

Abstract

An attempt was made to derive a useful noninvasive index to evalute a change in myocardial contractile state using transcutaneous Doppler flow-velocity curve from the carotid artery. In 5 mongrel dogs and in 43 patients with various heart disease, Doppler flow velocity curves were obtained from the ascending aorta intravascularly using a Doppler catheter and/or from carotid artery transcutaneously using a Doppler probe. The first derivative of left ventricular pressure (dp/dt) and electrocardiogram (ECG) were recorded simultaneously. The following 3 indices were measured from the Doppler flow-velocity curves: (1) macimum acceleration of blood flow (dv/dt), (2) time from onset of ejection to peak flow (time-to-peak), (3) time interval between the beginning of Q wave of ECG to the peak of Doppler flow velocity curve (ECG Q-Doppler peak). Among these 3 indices, only ECG Q-Doppler peak demonstrated a significant correlation between the values measured intravascularly and transcutaneously. Also, only ECG Q-Doppler peak showed significant correlation with maximum of dp/dt (max dp/dt). Since ECG Q-Doppler peak showed correlation with heart rate, the difference between observed and predicted ECG Q-Doppler peak (delta ECG Q-Doppler peak) was calculated to exclude the effect of heart rate. Predicted value of ECG Q-Doppler peak was calculated from the regression equation between heart rate and ECG Q-Doppler peak in the separate experiments. There was significant correlation between delta ECG Q-Doppler peak and max dp/dt. In 15 patients with coronary artery disease and in 16 healthy subjects, delta ECG Q-Doppler peak and the other noninvasive method (systolic time intervals) were measured. Delta ECG Q-Doppler peak showed better result in the separation of 2 groups than by systolic timeintervals. It was concluded that delta ECG Q-Doppler peak is a useful index to evaluate the myocardial contractile state since this index is readily obtained noninvasively.

摘要

尝试通过颈动脉的经皮多普勒血流速度曲线得出一个有用的非侵入性指标，以评估心肌收缩状态的变化。在5只杂种狗和43例患有各种心脏病的患者中，使用多普勒导管从升主动脉血管内和/或使用多普勒探头经皮从颈动脉获取多普勒血流速度曲线。同时记录左心室压力的一阶导数（dp/dt）和心电图（ECG）。从多普勒血流速度曲线测量以下3个指标：（1）血流最大加速度（dv/dt），（2）从射血开始到血流峰值的时间（达峰时间），（3）心电图Q波开始到多普勒血流速度曲线峰值之间的时间间隔（ECG Q-多普勒峰值）。在这3个指标中，只有ECG Q-多普勒峰值在血管内测量值和经皮测量值之间显示出显著相关性。此外，只有ECG Q-多普勒峰值与dp/dt最大值（max dp/dt）显示出显著相关性。由于ECG Q-多普勒峰值与心率相关，因此计算观察到的和预测的ECG Q-多普勒峰值之间的差异（δECG Q-多普勒峰值）以排除心率的影响。ECG Q-多普勒峰值的预测值是根据单独实验中心率与ECG Q-多普勒峰值之间的回归方程计算得出的。δECG Q-多普勒峰值与max dp/dt之间存在显著相关性。在15例冠心病患者和16例健康受试者中，测量了δECG Q-多普勒峰值和另一种非侵入性方法（收缩期时间间期）。与收缩期时间间期相比，δECG Q-多普勒峰值在两组分离中显示出更好的结果。得出结论，δECG Q-多普勒峰值是评估心肌收缩状态的有用指标，因为该指标易于通过非侵入性获得。