Tanaka Nobuaki
Department of Clinical Laboratory, Yamaguchi University Hospital, Ube 755-8508.
Rinsho Byori. 2003 Aug;51(8):751-60.
Noninvasive assessment of cardiac function by Doppler echocardiography is reviewed. The heart propels the blood through the repeated sequence of systole and diastole. The systolic function is essential to maintain the biological function of the whole body. However, before the heart ejects the blood during systole, the heart must be filled up with blood during the preceding diastole. Thus, the diastolic function is as important as the systolic function. Although the diastolic function is traditionally assessed by hemodynamic parameters obtained in the cardiac catheterization laboratory, it has routinely been assessed by Doppler echocardiography in the echocardiographic laboratory in recent years. Since the concept of diastolic failure has widely spread, the important role of the transmitral flow in assessing the diastolic function has been well recognized. Besides the transmitral flow, the modalities for clinical assessment of the left ventricular diastolic function have been well developed. For example, the pulmonary venous flow has been easily obtained by a transthoracic approach, and the tissue Doppler technique provides important information about the diastolic function, and furthermore the color M-mode is applied for the flow propagation velocity of the left ventricular inflow. These modalities make it possible to assess the left ventricular diastolic function more precisely by Doppler echocardiography. Also, TEI index, strain rate and strain imaging, and wave intensity are mentioned.
本文综述了通过多普勒超声心动图对心脏功能进行无创评估的方法。心脏通过收缩期和舒张期的反复循环来推动血液流动。收缩功能对于维持全身的生物学功能至关重要。然而，在心脏收缩期射出血液之前，心脏必须在之前的舒张期充满血液。因此，舒张功能与收缩功能同样重要。虽然传统上舒张功能是通过在心导管实验室获得的血流动力学参数来评估的，但近年来在超声心动图实验室中，通常是通过多普勒超声心动图来评估舒张功能的。自从舒张功能不全的概念广泛传播以来，二尖瓣血流在评估舒张功能中的重要作用已得到充分认识。除了二尖瓣血流外，左心室舒张功能的临床评估方法也得到了很好的发展。例如，经胸途径很容易获得肺静脉血流，组织多普勒技术提供了有关舒张功能的重要信息，此外，彩色M型用于测量左心室流入血流的传播速度。这些方法使得通过多普勒超声心动图更精确地评估左心室舒张功能成为可能。此外，还提到了TEI指数、应变率和应变成像以及波强度。
