Palka Przemysław, Lange Aleksandra, Atherton John, Stafford Wayne J, Burstow Darryl J
St Andrew's Heart Institute, Brisbane, Queensland, Australia.
Eur J Echocardiogr. 2004 Oct;5(5):356-66. doi: 10.1016/j.euje.2004.01.003.
To define biventricular diastolic behaviour in patients with cardiomyopathies with predominant diastolic left ventricular (LV) dysfunction.
Doppler tissue echocardiography and both mitral and tricuspid Doppler inflow profiles were investigated in hypertrophic (n = 17), hereditary hemochromatosis (n = 12) cardiomyopathies and age-matched normals (n = 31). The cardiomyopathy group had both lower early diastolic mitral lateral annular (El), cm/s (13.9 +/- 6.5) and medial (Em) (10.0 +/- 4.5) velocities compared with normals (19.5 +/- 5.5, 15.9 +/- 3.4, p < 0.01, respectively). In the cardiomyopathy group, late isovolumic relaxation myocardial velocity gradient (IVR-MVG) (s(-1)) was positive compared with negative in normals (1.3 +/- 1.3 vs. -0.7 +/- 1.4, p < 0.01, respectively). In both the cardiomyopathy group and in normals the onset of the tricuspid E-wave preceded the onset of the mitral E-wave. However, the onset of early diastolic tricuspid annular (Et) motion preceded the onset of El (ms) only in normals, but not in the cardiomyopathies (43 +/- 26 vs. -8 +/- 44, p < 0.01, respectively). In the cardiomyopathy group there was a positive correlation between the onset of Et and abnormally positive late IVR-MVG (r = 0.51, p = 0.002).
Biventricular early diastolic behaviour is abnormal in the selected group of cardiomyopathy patients. The delay in the Et (early diastolic longitudinal right ventricular relaxation) may have a negative effect on LV diastolic function.
明确以舒张期左心室（LV）功能障碍为主的心肌病患者的双心室舒张行为。
采用多普勒组织超声心动图以及二尖瓣和三尖瓣多普勒血流频谱，对肥厚型心肌病（n = 17）、遗传性血色素沉着症心肌病（n = 12）患者以及年龄匹配的正常对照者（n = 31）进行研究。与正常对照者（分别为19.5±5.5、15.9±3.4，p < 0.01）相比，心肌病组舒张早期二尖瓣外侧环（El）速度（cm/s）（13.9±6.5）和内侧（Em）速度（10.0±4.5）均较低。与正常对照者（分别为1.3±1.3与-0.7±1.4，p < 0.01）相比，心肌病组晚期等容舒张期心肌速度梯度（IVR-MVG）（s⁻¹）为正值。在心肌病组和正常对照者中，三尖瓣E波的起始均早于二尖瓣E波。然而，仅在正常对照者中，舒张早期三尖瓣环（Et）运动的起始早于El（ms），而在心肌病患者中并非如此（分别为43±26与-8±44，p < 0.01）。在心肌病组中，Et的起始与异常正向的晚期IVR-MVG之间存在正相关（r = 0.51，p = 0.002）。
在所选的心肌病患者组中，双心室舒张早期行为异常。Et（舒张早期右心室纵向舒张）延迟可能对左心室舒张功能产生负面影响。
