Fujimoto Sayuri, Oki Takashi, Tabata Tomotsugu, Tanaka Hideji, Yamada Hirotsugu, Oishi Yoshifumi, Ishimoto Takeo, Ito Susumu, Abe Yasuhiko, Kanda Ryoichi
Cardiovascular Section, National Higashi Tokushima Hospital, Tokushima, Japan.
Circ J. 2003 May;67(5):416-22. doi: 10.1253/circj.67.416.
The myocardial velocity profile (MVP) and gradient (MVG) between the endocardium and epicardium of the left ventricular (LV) wall measured by color-coded tissue Doppler imaging (TDI) are new indices for evaluating regional LV myocardial function. However, accurate recording and measurement of the MVP is difficult using conventional methodology because of the stochastic nature of the ultrasound signal; that is, the effect of speckled noise. The aim of this study was to validate the accuracy and establish the validity of a newly developed method for measuring the MVP and MVG using 10 clinically normal controls and 10 patients with a hypertensive hypertrophied LV posterior wall. A non-isotropic, averaging algorithm was developed that was capable of obtaining a stable MVP (averaged MVP). Averaged MVP was recorded using parasternal, LV short-axis, color-coded TDI, placing regions of interest along the LV posterior wall with the reference point for angle-correction being at the center of LV contraction. The velocity from epicardium to endocardium within the region of interest was automatically angle-corrected to calculate the velocity component radially relative to the LV cavity and was spatially averaged along the circumference within the region of interest. Inter- and intraobserber variabilities of measurements were lower in the averaged MVP and MVG than in the conventional MVP and MVG. The correlation coefficients of the linear regression lines of systolic and early diastolic MVPs in the LV posterior wall were higher in all controls and hypertensive patients with the averaged method than with the conventional TDI procedures. The mean peak systolic and early diastolic MVGs were lower in the hypertensive group than in the controls. In conclusion, the newly developed averaged MVP provides a stable and reproducible index for the quantitative assessment of regional LV myocardial function.
通过彩色编码组织多普勒成像（TDI）测量的左心室（LV）壁心内膜与心外膜之间的心肌速度剖面图（MVP）和梯度（MVG）是评估局部LV心肌功能的新指标。然而，由于超声信号的随机性，即斑点噪声的影响，使用传统方法很难准确记录和测量MVP。本研究的目的是使用10名临床正常对照者和10名高血压性LV后壁肥厚患者，验证一种新开发的测量MVP和MVG方法的准确性并确立其有效性。开发了一种非各向同性的平均算法，该算法能够获得稳定的MVP（平均MVP）。使用胸骨旁LV短轴彩色编码TDI记录平均MVP，将感兴趣区域沿LV后壁放置，角度校正的参考点位于LV收缩中心。感兴趣区域内心外膜到心内膜的速度会自动进行角度校正，以计算相对于LV腔的径向速度分量，并在感兴趣区域内沿圆周进行空间平均。平均MVP和MVG测量的观察者间和观察者内变异性低于传统MVP和MVG。在所有对照者和高血压患者中，LV后壁收缩期和舒张早期MVP线性回归线的相关系数，平均法高于传统TDI程序。高血压组的平均收缩期峰值和舒张早期MVG低于对照组。总之，新开发的平均MVP为局部LV心肌功能的定量评估提供了一个稳定且可重复的指标。
