Assmann P E, Slager C J, van der Borden S G, Dreysse S T, Tijssen J G, Sutherland G R, Roelandt J R
Department of Clinical Echocardiography, Thoraxcenter, Erasmus University, The Netherlands.
J Am Soc Echocardiogr. 1990 Nov-Dec;3(6):478-87. doi: 10.1016/s0894-7317(14)80364-7.
We recorded two-dimensional echocardiograms simultaneously with the respiration measurements of 20 normal subjects and 20 patients with anterior myocardial infarction. The apical long-axis and four-chamber views were quantitatively analyzed. Measurement variability of global ejection fraction and regional ejection fraction of 100 regions was calculated during inspiration and at end-expiration for two observers. To minimize variability, the endocardial contour was redefined and traced with an improved computer-assisted tracing system. Variability (absolute mean difference) between two beats at end-expiration was significantly less than during inspiration (p less than 0.05): for ejection fraction the variability at end-expiration was 3.4% and the variability during inspiration was 6.4% (mean, 54%; SD, 7%); for regional ejection fraction the variability at end-expiration was 11.8% and the variability during inspiration was 21.5% (mean, 56%; SD, 15%). Intraobserver and interobserver variability values of one beat at end-expiration for ejection fraction were 3.1% and 3.8%, respectively, and 9.5% and 12.8%, respectively, for regional ejection fraction. Variability in patients with myocardial infarction was comparable. This method of recording respiration and analyzing left ventricular function at end-expiration, with a new contour definition and tracing system, provides a measurement variability that is considerably less than that reported in previous echocardiographic studies and that is comparable to angiographic methods.
我们对20名正常受试者和20名前壁心肌梗死患者在进行呼吸测量的同时记录二维超声心动图。对心尖长轴和四腔心切面进行定量分析。由两名观察者计算100个区域的整体射血分数和局部射血分数在吸气期和呼气末的测量变异性。为使变异性最小化，采用改进的计算机辅助追踪系统重新定义并描绘心内膜轮廓。呼气末两搏之间的变异性（绝对平均差）显著小于吸气期（p<0.05）：射血分数方面，呼气末的变异性为3.4%，吸气期的变异性为6.4%（均值，54%；标准差，7%）；局部射血分数方面，呼气末的变异性为11.8%，吸气期的变异性为21.5%（均值，56%；标准差，15%）。呼气末单搏射血分数的观察者内和观察者间变异性值分别为3.1%和3.8%，局部射血分数分别为9.5%和12.8%。心肌梗死患者的变异性与之相当。这种在呼气末记录呼吸并分析左心室功能的方法，采用新的轮廓定义和追踪系统，所提供的测量变异性远小于以往超声心动图研究报道的变异性，且与血管造影方法相当。
