Polak Joseph F, Alessi-Chinetti Jean M, Patel Ayan R, Estes James M
Departments of Radiology (J.F.P.) and Vascular Surgery (J.M.A.-C., J.M.E.) and Division of Cardiology/Cardiovascular Center (J.M.A.-C., A.R.P.), Tufts Medical Center, Boston, Massachusetts USA.
J Ultrasound Med. 2015 Mar;34(3):461-7. doi: 10.7863/ultra.34.3.461.
The appearance of the dicrotic notch on blood pressure tracings is associated with impaired cardiac function. Common carotid artery waveforms have similar fiduciary markers, yet they have not been related to cardiac function. We studied associations of common carotid artery dicrotic notch velocities with the left ventricular ejection fraction (LVEF) determined by echocardiography.
We conducted a retrospective study of 37 patients who had cardiac echocardiography and carotid Doppler evaluations within 1 day of each other. The LVEF was determined by the biplane modified Simpson rule. Doppler parameters were measured from tracings of the left common carotid artery 4 cm from the flow divider. Linear regression and stepwise multivariable linear regression models were used to evaluate any association between the LVEF and the following variables: age, sex, peak systolic velocity (PSV), end-diastolic velocity (EDV), dicrotic notch velocity, rise time (EDV to PSV), resistive index, and cardiac cycle length.
The dicrotic notch velocity was the only variable associated with the LVEF (P = .028) in a bivariate analyses. A backward selection stepwise multivariable equation predicting the LVEF had the dicrotic notch (P = .001) and resistive index (P = .01) as significant predictors, whereas the cardiac cycle length (P = .08) and PSV (P = .08) were borderline not significant. Model goodness of fit was R(2) = 0.37 (P = .004).
Dicrotic notch velocities measured from common carotid artery Doppler waveforms are associated with the LVEF and might offer some clinical value in selected cases.
血压描记图上重搏波切迹的出现与心功能受损有关。颈总动脉波形有类似的基准标记，但它们与心功能的关系尚未明确。我们研究了颈总动脉重搏波切迹速度与经超声心动图测定的左心室射血分数（LVEF）之间的关联。
我们对37例在1天内先后接受心脏超声心动图和颈动脉多普勒评估的患者进行了一项回顾性研究。LVEF通过双平面改良Simpson法则测定。多普勒参数从距分流器4 cm处的左颈总动脉描记图中测量。采用线性回归和逐步多变量线性回归模型来评估LVEF与以下变量之间的任何关联：年龄、性别、收缩期峰值速度（PSV）、舒张末期速度（EDV）、重搏波切迹速度、上升时间（从EDV到PSV）、阻力指数和心动周期长度。
在双变量分析中，重搏波切迹速度是与LVEF相关的唯一变量（P = 0.028）。一个预测LVEF的向后选择逐步多变量方程中，重搏波切迹（P = 0.001）和阻力指数（P = 0.01）是显著预测因子，而心动周期长度（P = 0.08）和PSV（P = 0.08）接近不显著。模型拟合优度为R(2) = 0.37（P = 0.004）。
从颈总动脉多普勒波形测量的重搏波切迹速度与LVEF相关，在某些特定情况下可能具有一定临床价值。
