Zhang Haibin, Song Yan, Zhu Yongsheng, Li Hongling, Zhu Ting, Qian Yunqiu, Liu Liwen, Zhang Jun, Zhou Xiaodong, Zhu Miaozhang
Department of Physiology, Xijing Hospital, Fourth Military Medical Unviersity, Xi'an, China.
Echocardiography. 2008 Mar;25(3):278-88. doi: 10.1111/j.1540-8175.2007.00595.x.
The early diastolic peak velocity of left ventricular (LV) wall segment has always been thought to appear in the rapid filling phase. However, we find a segmental early relaxation phenomenon (SERP), characterized by an early diastolic peak velocity lying in the isovolumic relaxation (IVR) period. The present study aimed to investigate the characteristics of SERP segments with tissue Doppler imaging (TDI) echocardiography.
TDI was performed in 119 patients with known or suspected coronary heart disease (CHD) and 60 normal subjects. The segmental early diastolic velocity pattern was classified as normal pattern (NP), postsystolic shortening (PSS) and SERP.
Segmental early diastolic velocity pattern was significantly associated with actual coronary diameter stenosis, relative coronary stenosis, wall motion score, and segmental location in LV wall. Compared with other segments, SERP segments had a higher IVR velocity and lower early diastolic peak velocity.
SERP most frequently occurs in the distribution of artery with the relatively mildest stenosis, and is more likely accompanied by simultaneous PSS elsewhere in LV wall, which occurs most frequently in the distribution of artery with the relatively most severe stenosis. A decreased early diastolic peak velocity of SERP segment dose not necessarily mean impaired myocardial relaxation.
左心室壁节段的舒张早期峰值速度一直被认为出现在快速充盈期。然而，我们发现了一种节段性早期舒张现象（SERP），其特征是舒张早期峰值速度出现在等容舒张期。本研究旨在利用组织多普勒成像（TDI）超声心动图研究SERP节段的特征。
对119例已知或疑似冠心病（CHD）患者和60例正常受试者进行TDI检查。将节段性舒张早期速度模式分为正常模式（NP）、收缩后缩短（PSS）和SERP。
节段性舒张早期速度模式与实际冠状动脉直径狭窄、相对冠状动脉狭窄、壁运动评分以及左心室壁节段位置显著相关。与其他节段相比，SERP节段等容舒张期速度较高，舒张早期峰值速度较低。
SERP最常出现在狭窄程度相对最轻的动脉分布区域，且更可能同时伴有左心室壁其他部位的PSS，PSS最常出现在狭窄程度相对最严重的动脉分布区域。SERP节段舒张早期峰值速度降低不一定意味着心肌舒张功能受损。
