Brodie B R, McLaurin L P, Grossman W
Am J Cardiol. 1976 May;37(6):864-70. doi: 10.1016/0002-9149(76)90111-9.
Calculation of left ventricular wall stress in man has traditionally required angiographic and left ventricular pressure measurement, making study of interventions difficult. We have developed a combined hemodynamic-ultrasonic technique for measuring left ventricular meridional wass stress (sigma m) throughout the cardiac cycle. Simultaneous measurements of left ventricular pressure, ultrasonically determined wall thickness (h[echo]), and minor axis (D[echol]) were made during cardiac catheterization in nine subjects, three with chronic left ventricular pressure overload, four with left ventricular volume overload and two with normal left ventricular function. Within 30 minutes, left ventricular cineangiography was performed in each subject and angiographic wall thickness (h[angio]) and minor axis (D[angio]) were measured. Comparison of values for each subject throughout the cardiac cycle (average 18 data points/cycle) yielded close correlation: For D(echo) versus D(angio), r values ranged from 0.82 to 0.98 whereas for h(echo) versus h(angio), r values ranged from 0.56 to 0.98 for the nine subjects. Meridional wall stress was calculated after the method of Sandler and Dodge as PRi2/h(2Ri + h), where Ri equals the inner wall radius, calculated as D/2 for both ultrasonic and angiographic methods. Agreement between ultrasonic and angiographic methods was excellent in each subject, with close superimposition of the stress-time plots constructed by the different techniques. In summary, a new method for measurement of left ventricular wall stress has been developed and validated by comparison with an angiographic reference standard. This method has potential advantages, including the ability to study meridional wall stress continuously and to assess its response to serial interventions.
传统上，计算人体左心室壁应力需要进行血管造影和左心室压力测量，这使得对干预措施的研究变得困难。我们开发了一种联合血流动力学 - 超声技术，用于测量整个心动周期中的左心室子午线壁应力（σm）。在9名受试者进行心导管检查期间，同时测量了左心室压力、超声测定的壁厚（h[回声]）和短轴（D[回声]），其中3名患有慢性左心室压力过载，4名患有左心室容量过载，2名左心室功能正常。在30分钟内，对每个受试者进行了左心室电影血管造影，并测量了血管造影的壁厚（h[血管造影]）和短轴（D[血管造影]）。比较每个受试者在整个心动周期中的值（平均每个周期18个数据点）得出了密切的相关性：对于D（回声）与D（血管造影），r值范围为0.82至0.98，而对于h（回声）与h（血管造影），9名受试者的r值范围为0.56至0.98。子午线壁应力按照Sandler和Dodge的方法计算为PRi2/h(2Ri + h)，其中Ri等于内壁半径，超声和血管造影方法均计算为D/2。超声和血管造影方法在每个受试者中一致性极佳，不同技术构建的应力 - 时间图紧密重叠。总之，已开发出一种测量左心室壁应力的新方法，并通过与血管造影参考标准比较进行了验证。该方法具有潜在优势，包括能够连续研究子午线壁应力并评估其对系列干预的反应。
