Ohte N, Nakano S, Hashimoto T, Narita H, Fujinami T
Third Department of Internal Medicine, Nagoya City University Medical School.
J Cardiol. 1990;20(2):457-64.
Left ventricular function was evaluated using parameters derived from the flow velocity waveforms at the ascending aorta as obtained at the suprasternal notch by continuous-wave Doppler echocardiography in 39 patients; 12 with chest pain but without coronary stenosis, eight with angina pectoris; and 19 with myocardial infarction. Peak flow velocity and the time interval from the beginning of the Q wave of lead II of the ECG to peak flow velocity (Q-V peak) correlated with specific invasive hemodynamic parameters, such as max dp/dt and (max dp/dt)/IP (IP: total left ventricular pressure at the same instant) during isometric contraction of the left ventricle measured with a catheter tip manometer, and left ventricular ejection fraction (LVEF) obtained by bi-plane cineangiography (using the area-length method). There was no correlation between the peak flow velocity and the invasive hemodynamic parameters. However, significant negative correlations were observed between the Q-V peak time and max dp/dt, with r = 0.40 (p less than 0.05), and between the Q-V peak time and (max dp/dt)/IP with r = -0.61 (p less than 0.01). A negative correlation was obtained between the Q-V peak time and LVEF (r = -0.75, p less than 0.01). The regression equation was LVEF = -0.67 x (Q-V peak) + 176. To compare the effectiveness for predicting LVEF between the Q-V peak and the established systolic time intervals as PEP and PEP/ET, these time intervals were measured from flow velocity waveforms invasively obtained with a catheter-type electromagnetic flowmeter inserted into the ascending aorta in 14 patients selected from the original subjects.(ABSTRACT TRUNCATED AT 250 WORDS)
在39例患者中,采用连续波多普勒超声心动图在胸骨上切迹获取升主动脉流速波形所衍生的参数,对左心室功能进行评估;其中12例胸痛但无冠状动脉狭窄,8例心绞痛,19例心肌梗死。峰值流速以及心电图Ⅱ导联Q波起始至峰值流速的时间间隔(Q-V峰值),与特定的有创血流动力学参数相关,例如用导管顶端压力计测量左心室等容收缩期的最大dp/dt和(最大dp/dt)/IP(IP:同一时刻的左心室总压力),以及通过双平面心血管造影(采用面积-长度法)获得的左心室射血分数(LVEF)。峰值流速与有创血流动力学参数之间无相关性。然而,观察到Q-V峰值时间与最大dp/dt之间存在显著负相关,r = 0.40(p < 0.05),Q-V峰值时间与(最大dp/dt)/IP之间存在显著负相关,r = -0.61(p < 0.01)。Q-V峰值时间与LVEF之间存在负相关(r = -0.75,p < 0.01)。回归方程为LVEF = -0.67×(Q-V峰值)+ 176。为比较Q-V峰值与既定的收缩期时间间隔(如PEP和PEP/ET)预测LVEF的有效性,在从原始受试者中选取的14例患者中,通过插入升主动脉的导管式电磁流量计有创获取流速波形来测量这些时间间隔。(摘要截取自250字)