JACC Cardiovasc Imaging. 2011 Jan;4(1):37-46. doi: 10.1016/j.jcmg.2010.09.020.
this study evaluated early diastolic filling dynamics using a semiautomated objective analysis of filling velocities obtained from color M-mode echocardiography.
diastolic function can be evaluated from color M-mode echocardiography by measuring the early diastolic flow propagation velocity (Vp) from the slope of a single linear approximation of an isovelocity contour. However, this method has limitations and may not accurately represent diastolic filling.
we used a semiautomated objective analysis of color M-mode echocardiograms from a development cohort of 125 patients with varying diastolic function to quantify left ventricular filling velocities. Early diastolic filling was not accurately described with a single propagation velocity; instead, the rapid initial filling velocity abruptly decelerated to a slower terminal velocity. Then, we evaluated a new measure of diastolic function in a separate group of 160 patients.
compared with normal filling, diastolic dysfunction with restricted filling had a lower initial velocity (53 ± 21 cm/s vs. 87 ± 29 cm/s, p < 0.001), and the deceleration point occurred closer to the mitral annulus (2.4 ± 0.6 cm vs. 3.1 ± 0.7 cm, p < 0.05). The product of the initial velocity and the distance to the deceleration point from the mitral annulus, indicating the strength of the early filling (Vs), was progressively reduced with diastolic dysfunction. In a separate validation cohort of 160 patients, Vs better recognized diastolic dysfunction (classified by reduced diastolic intraventricular pressure gradient, elevated pulmonary capillary wedge pressure, or elevated B-type natriuretic peptide) than Vp did.
early diastolic flow propagation occurs with an initial rapid velocity that abruptly decelerates to a terminal velocity. With diastolic dysfunction, the initial velocity is slower and the deceleration point occurs closer to the mitral annulus than with normal filling. A new parameter that combines these 2 effects (Vs) provides a more accurate assessment of diastolic function than the conventional propagation velocity.
本研究通过彩色 M 型超声心动图半自动化客观分析充盈速度，评估舒张早期充盈动力学。
通过测量等速轮廓的单个线性近似斜率，可从彩色 M 型超声心动图评估舒张功能，得到舒张早期血流传播速度（Vp）。然而，这种方法存在局限性，可能无法准确反映充盈情况。
我们使用从具有不同舒张功能的 125 例患者的发展队列中获取的彩色 M 型超声心动图的半自动化客观分析，定量评估左心室充盈速度。快速早期充盈速度突然减速至较慢的终末速度，而非单一传播速度可准确描述早期充盈。然后，我们在另外一组 160 例患者中评估了一种新的舒张功能指标。
与正常充盈相比，限制充盈的舒张功能障碍患者初始速度较低（53±21cm/s 比 87±29cm/s，p＜0.001），且减速点更靠近二尖瓣环（2.4±0.6cm 比 3.1±0.7cm，p＜0.05）。初始速度与从二尖瓣环到减速点的距离的乘积（即早期充盈强度 Vs）随着舒张功能障碍逐渐降低。在另外一组 160 例患者的验证队列中，Vs 比 Vp 更好地识别舒张功能障碍（通过降低舒张期室内压力梯度、升高肺毛细血管楔压或升高 B 型利钠肽来分类）。
舒张早期血流传播开始时速度较快，然后突然减速至终末速度。与正常充盈相比，舒张功能障碍患者的初始速度较慢，且减速点更靠近二尖瓣环。综合这两种效应的新参数（Vs）比传统传播速度能更准确地评估舒张功能。
