Nikitin Nikolay P, Witte Klaus K A, Thackray Simon D R, de Silva Ramesh, Clark Andrew L, Cleland John G F
Department of Cardiology, University of Hull School of Medicine, Cottingham, Kingston upon Hull, United Kingdom.
J Am Soc Echocardiogr. 2003 Sep;16(9):906-21. doi: 10.1016/S0894-7317(03)00279-7.
Quantitative 2-dimensional color Doppler tissue imaging is a new method to reveal impairment of left ventricular (LV) and right ventricular (RV) longitudinal function, which is a potential marker of early myocardial disease. The aim of this study was to obtain normal values for atrioventricular annular and regional myocardial velocities using this method.
A total of 123 healthy patients (age range: 22 to 89 years) underwent echocardiography including color Doppler tissue imaging using a scanner (Vivid 5, GE Vingmed, Horten, Norway) with postprocessing analysis (Echopac 6.3, GE Vingmed). Regional myocardial velocities were measured at 12 LV segments in 3 apical views and 2 segments of the free RV wall. Mitral annular velocities from 6 sites, and tricuspid annular velocities at its lateral site, were also assessed. At each site, systolic (S(m)), early diastolic (E(m)), and late diastolic (A(m)) velocities were measured, and the E(m)/A(m) ratio was calculated.
Patients were classified into 4 groups aged 20 to 39, 40 to 59, 60 to 79, and >/=80 years. Mitral annular velocity and regional LV myocardial S(m) and E(m) progressively decreased with age. A(m), whereas low in the youngest age group, increased significantly in patients more than 40 years of age. The E(m)/A(m) ratio gradually declined with aging. There were no differences between age groups in S(m) measured at the tricuspid annulus and free RV wall, but the pattern of age-related changes of diastolic velocities and E(m)/A(m) ratio was the same as in the LV. Slight but significant sex-related differences were observed in middle-aged groups. The intraobserver and interobserver reproducibility was highest for atrioventricular annular velocities.
A progressive decrease in S(m) reveals a decline in longitudinal systolic LV function with age, whereas systolic RV function remains unaffected. Atrioventricular annular velocity and regional E(m) decrease with aging in both ventricles, suggesting a deterioration in the diastolic properties of the myocardium, whereas A(m) increases from middle age implying a compensatory augmentation of atrial function. The study results can be used as reference data for the quantitative assessment of longitudinal LV and RV function in patients with cardiac disease.
定量二维彩色多普勒组织成像技术是一种揭示左心室（LV）和右心室（RV）纵向功能受损的新方法，这是早期心肌疾病的一个潜在标志物。本研究的目的是使用该方法获得房室环和局部心肌速度的正常值。
共有123例健康患者（年龄范围：22至89岁）接受了超声心动图检查，包括使用一台扫描仪（Vivid 5，通用电气维迪美公司，挪威霍滕）进行彩色多普勒组织成像，并进行后处理分析（Echopac 6.3，通用电气维迪美公司）。在3个心尖视图中的12个左心室节段和右心室游离壁的2个节段测量局部心肌速度。还评估了二尖瓣环6个部位的速度以及三尖瓣环外侧部位的速度。在每个部位测量收缩期（S(m)）、舒张早期（E(m)）和舒张晚期（A(m)）速度，并计算E(m)/A(m)比值。
患者分为4组，年龄分别为20至39岁、40至59岁、60至79岁和≥80岁。二尖瓣环速度以及左心室局部心肌的S(m)和E(m)随年龄逐渐降低。A(m)在最年轻年龄组较低，但在40岁以上患者中显著增加。E(m)/A(m)比值随年龄逐渐下降。三尖瓣环和右心室游离壁处测量的S(m)在各年龄组之间无差异，但舒张期速度和E(m)/A(m)比值与年龄相关的变化模式与左心室相同。在中年组中观察到轻微但显著的性别差异。房室环速度的观察者内和观察者间重复性最高。
S(m)的逐渐降低表明左心室纵向收缩功能随年龄下降，而右心室收缩功能不受影响。两心室的房室环速度和局部E(m)随年龄降低，提示心肌舒张特性恶化，而A(m)从中年开始增加，意味着心房功能的代偿性增强。研究结果可作为心脏病患者左心室和右心室纵向功能定量评估的参考数据。
