Miyaguchi K, Iwase M, Yokota M, Hayashi H
First Department of Internal Medicine, Nagoya University School of Medicine, Japan.
Am Heart J. 1991 Jul;122(1 Pt 1):142-8. doi: 10.1016/0002-8703(91)90771-9.
In previous reports that evaluated pulsed Doppler transmitral filling, the sampling site has varied; we examined the effect of the sample volume location on Doppler measurements. Studied were 97 patients: 58 with normal echocardiograms, 20 with mitral regurgitation, and 19 with miscellaneous cardiac diseases. Transmitral filling was recorded at the mitral anulus and at the left atrial and left ventricular (LV) sides of the mitral tips. As the sample volume was moved from the mitral anulus to the LV side, the peak velocity and time-velocity integral of early diastole increased (40.6 +/- 13.8 versus 59.0 +/- 19.0 cm/sec, 5.26 +/- 1.65 versus 8.35 +/- 2.37 cm; p less than 0.001) as did those of late diastole (48.7 +/- 11.5 versus 57.5 +/- 17.0 cm/sec, 3.48 +/- 0.97 versus 4.59 +/- 1.39 cm; p less than 0.001). The late-to-early diastolic peak velocity and time-velocity integral ratios and the late-to-total diastolic time-velocity integral ratio decreased (1.33 +/- 0.51 versus 1.06 +/- 0.41, 0.71 +/- 0.24 versus 0.58 +/- 0.19, 0.40 +/- 0.09 versus 0.36 +/- 0.08; p less than 0.001). The dependency of these indices on the sampling site was in the same degree in all three groups. However, the peak filling rate normalized to mitral stroke volume (4.71 +/- 1.43 versus 4.63 +/- 1.32 l/sec; p = NS) was not influenced by the sample volume location; thus this parameter may be more reliable for assessing LV filling.
在之前评估脉冲多普勒二尖瓣血流充盈的报告中，取样部位各不相同；我们研究了取样容积位置对多普勒测量的影响。研究对象为97例患者：58例超声心动图正常，20例有二尖瓣反流，19例有其他心脏疾病。在二尖瓣环以及二尖瓣叶尖的左心房和左心室侧记录二尖瓣血流充盈情况。当取样容积从二尖瓣环移至左心室侧时，舒张早期的峰值速度和时间速度积分增加（40.6±13.8对59.0±19.0厘米/秒，5.26±1.65对8.35±2.37厘米；p<0.001），舒张晚期的情况也如此（48.7±11.5对57.5±17.0厘米/秒，3.48±0.97对4.59±1.39厘米；p<0.001）。舒张晚期与早期峰值速度比和时间速度积分比以及舒张晚期与总舒张期时间速度积分比降低（1.33±0.51对1.06±0.41，0.71±0.24对0.58±0.19，0.40±0.09对0.36±0.08；p<0.001）。所有三组中这些指标对取样部位的依赖性程度相同。然而，以二尖瓣每搏量标准化的峰值充盈率（4.71±1.43对4.63±1.32升/秒；p=无显著性差异）不受取样容积位置的影响；因此该参数在评估左心室充盈方面可能更可靠。
