Bogunovic Nikola, van Buuren Frank, Esdorn Hermann, Horstkotte Dieter, Bogunovic Lukas, Faber Lothar
Clinic for Cardiology, Herz- und Diabeteszentrum NRW, Ruhr-Universität Bochum, Bad Oeynhausen, Germany.
Institute for Radiology, Nuclear Medicine and Molecular Imaging, Herz- und Diabeteszentrum NRW, Ruhr-Universität Bochum, Bad Oeynhausen, Germany.
Echocardiography. 2018 Dec;35(12):1947-1955. doi: 10.1111/echo.14191. Epub 2018 Nov 8.
We investigated physiological systolic left ventricular (LV) myocardial mechanics and gradients to provide a database for later studies of diseased hearts.
The analyses were performed in 131 heart-healthy individuals and included seven parameters of myocardial mechanics using speckle tracking echocardiography (STE).
Basal to apical and circumferentially significant physiological intraventricular parameter gradients of myocardial activity were determined. Global mean values and segmental ranges were peak systolic longitudinal strain -21.2 ± 3.3%, 95% confidence interval [CI] -21.8% to -20.6%), gradient (basal to apical) -16.0% to -26.7%; peak systolic longitudinal strain rate -1.24 ± 0.31%/s, 95% CI -1.29% to -1.19%/s, gradient (basal to apical) -0.91% to -1.61%/s; post-systolic index 2.6 ± 3.2%, 95% CI 3.15%-2.05%, gradient (basal/medial/apical) 7.0/1.2/2.4%; pre-systolic stretch index 1.3 ± 2.7%, 95% CI 1.77%-0.83%, gradient (basal/medial/apical) 6.5/0.2/1.3%; peak longitudinal displacement 12.2 ± 2.6 mm, 95% CI 12.6-11.8 mm, gradient (basal to apical) 21.0-3.4 mm; time-to-peak longitudinal strain 370 ± 43 ms, 95% CI 377-363 ms, gradient (basal to apical) 396-361 ms; and time-to-peak longitudinal strain rate 180 ± 47 ms, 95% CI 188-172 ms, gradient (basal to apical) 150-200 ms.
This study generated a database of seven STE-derived parameters of physiological segmental and global myocardial LV mechanics. The resulting sets of three-dimensional intraventricular mappings of the entire LV provide physiological parameter gradients in baso-apical and circumferential direction by applying the 17-segment polar model. This will facilitate comparison of systolic myocardial activity of the healthy LV with diseased or otherwise altered (eg, sports) hearts.
我们研究了生理性收缩期左心室（LV）心肌力学及梯度，以建立一个数据库，供日后对患病心脏进行研究使用。
对131名心脏健康的个体进行了分析，使用斑点追踪超声心动图（STE）测量了七个心肌力学参数。
确定了从心底到心尖以及圆周方向上显著的生理性心室内心肌活动参数梯度。整体平均值和节段范围分别为：收缩期峰值纵向应变-21.2±3.3%，95%置信区间[CI]-21.8%至-20.6%，梯度（心底到心尖）-16.0%至-26.7%；收缩期峰值纵向应变率-1.24±0.31%/秒，95%CI-1.29%至-1.19%/秒，梯度（心底到心尖）-0.91%至-1.61%/秒；收缩后期指数2.6±3.2%，95%CI 3.15%-2.05%，梯度（心底/中间/心尖）7.0/1.2/2.4%；收缩前期拉伸指数1.3±2.7%，95%CI 1.77%-0.83%，梯度（心底/中间/心尖）6.5/0.2/1.3%；峰值纵向位移12.2±2.6毫米，95%CI 12.6-11.8毫米，梯度（心底到心尖）21.0-3.4毫米；达到峰值纵向应变的时间370±43毫秒，95%CI 377-363毫秒，梯度（心底到心尖）396-361毫秒；以及达到峰值纵向应变率的时间180±47毫秒，95%CI 188-172毫秒，梯度（心底到心尖）150-200毫秒。
本研究生成了一个包含七个STE衍生的生理性节段性和整体左心室心肌力学参数的数据库。通过应用17节段极坐标模型，得到的整个左心室三维心室内映射集提供了心底-心尖和圆周方向的生理参数梯度。这将有助于比较健康左心室与患病或其他改变（如运动）心脏的收缩期心肌活动。
