Mora Vicente, Roldán Ildefonso, Romero Elena, Romero Diana, Bertolín Javier, Ugalde Natalia, Pérez-Olivares Carmen, Rodriguez-Israel Melisa, Pérez-Gozalbo Jana, Lowenstein Jorge A
Cardiology Department, Hospital Dr Peset, Valencia, Spain.
Cardiodiagnosis Department Medical Research of Buenos Aires, Buenos Aires, Argentina.
Cardiovasc Ultrasound. 2018 Sep 18;16(1):16. doi: 10.1186/s12947-018-0135-x.
Left ventricular ejection fraction (LVEF) results from the combined action of longitudinal and circumferential contraction, radial thickening, and basal and apical rotation. The study of these parameters together may lead to an accurate assessment of the cardiac function.
Ninety healthy volunteers, categorized by gender and age (≤ 55 and > 55 years), were evaluated using two-dimensional speckle tracking echocardiography. Transversal views of the left ventricle (LV) were obtained to calculate circumferential strain and left ventricular twist, while three apical views were obtained to determine longitudinal strain (LS) and mitral annular plane systolic excursion (MAPSE). We established the integral myocardial function of the LV according to: 1. The Combined Deformation Parameter (CDP), which includes Deformation Product (DP) - Twist x LS (° x %) - and Deformation Index (DefI) -Twist / LS (° / %)-; and 2. the Torsion Index (TorI): Twist / MAPSE (° / cm).
The mean age of our patients was 50.3 ± 11.1 years. CDP did not vary with gender or age. The average DP was - 432 ± 172 ° x %, and the average DefI was - 0.96 ± 0.36 ° / %. DP provides information about myocardial function (normal, pseudonormal, depressed), and the DefI quotient indicates which component (s) is/are affected in cases of abnormality. TorI was higher in volunteers over 55 years (16.5 ± 15.2 vs 13.1 ± 5.0 °/cm, p = 0.003), but did not vary with gender.
The proposed parameters integrate values of twisting and longitudinal shortening. They allow a complete physiological assessment of cardiac systolic function, and could be used for the early detection and characterization of its alteration.
左心室射血分数（LVEF）是纵向和圆周收缩、径向增厚以及基底和心尖旋转共同作用的结果。对这些参数进行综合研究可能会实现对心功能的准确评估。
采用二维斑点追踪超声心动图对90名按性别和年龄（≤55岁和＞55岁）分类的健康志愿者进行评估。获取左心室（LV）的横向视图以计算圆周应变和左心室扭转，同时获取三个心尖视图以确定纵向应变（LS）和二尖瓣环平面收缩期位移（MAPSE）。我们根据以下内容建立LV的整体心肌功能：1. 联合变形参数（CDP），包括变形乘积（DP）——扭转×LS（°×%）——和变形指数（DefI）——扭转/LS（°/%）——；2. 扭转指数（TorI）：扭转/MAPSE（°/cm）。
我们患者的平均年龄为50.3±11.1岁。CDP不随性别或年龄变化。平均DP为-432±172°×%，平均DefI为-0.96±0.36°/%。DP提供有关心肌功能（正常、假性正常、降低）的信息，并且DefI商数表明在异常情况下受影响的是哪些成分。55岁以上志愿者的TorI更高（16.5±15.2 vs 13.1±5.0°/cm，p = 0.003），但不随性别变化。
所提出的参数整合了扭转和纵向缩短的值。它们能够对心脏收缩功能进行完整的生理评估，并可用于其改变的早期检测和特征描述。
