Oh J K, Ding Z P, Gersh B J, Bailey K R, Tajik A J
Division of Cardiovascular Diseases and Internal Medicine, Mayo Clinic, Rochester, MN 55905.
J Am Soc Echocardiogr. 1992 Sep-Oct;5(5):497-503. doi: 10.1016/s0894-7317(14)80041-2.
Left ventricular diastolic filling was characterized by transmitral pulsed-wave Doppler velocities in 62 patients with acute myocardial infarction, and diastolic filling variables were correlated with the presence of clinical heart failure. At the time of admission, 47 patients were free of heart failure and 15 patients were in Killip class II to IV. In the latter group of patients with heart failure, peak velocity of late filling wave caused by atrial contraction (A) was lower (0.48 versus 0.59 m/sec, p < 0.05), ratio of peak velocity of early rapid filling wave to peak velocity of late filling wave caused by atrial contraction (E/A) was higher (1.5 versus 1.1, p < 0.01), and deceleration time (136 versus 196 msec, p = 0.0001) was shorter when compared with the patients not in heart failure after acute myocardial infarction. Multivariate analysis showed that the deceleration time was a powerful independent predictor of presence of heart failure after controlling for systolic functional variables. Therefore, diastolic filling variables can complement systolic functional variables in the identification of the patients with postinfarction left ventricular failure.
采用经二尖瓣脉冲波多普勒速度对62例急性心肌梗死患者的左心室舒张期充盈情况进行了分析，舒张期充盈变量与临床心力衰竭的存在情况相关。入院时，47例患者无心力衰竭，15例患者为Killip II至IV级。在后一组心力衰竭患者中，心房收缩引起的晚期充盈波峰值速度（A）较低（0.48对0.59米/秒，p<0.05），早期快速充盈波峰值速度与心房收缩引起的晚期充盈波峰值速度之比（E/A）较高（1.5对1.1，p<0.01），与急性心肌梗死后无心力衰竭的患者相比，减速时间更短（136对196毫秒，p=0.0001）。多变量分析表明，在控制收缩功能变量后，减速时间是心力衰竭存在的有力独立预测指标。因此，舒张期充盈变量可在识别梗死后左心室衰竭患者时补充收缩功能变量。
