Department of Cardiology, Erasmus MC, Rotterdam, The Netherlands.
Department of Biomedical Engineering, Erasmus MC, Rotterdam, The Netherlands.
Ultrasound Med Biol. 2019 Aug;45(8):1977-1986. doi: 10.1016/j.ultrasmedbio.2019.04.004. Epub 2019 May 10.
We apply a high frame rate (over 500 Hz) tissue Doppler method to measure the propagation velocity of naturally occurring shear waves (SW) generated by aortic and mitral valves closure. The aim of this work is to demonstrate clinical relevance. We included 45 healthy volunteers and 43 patients with hypertrophic cardiomyopathy (HCM). The mitral SW (4.68 ± 0.66 m/s) was consistently faster than the aortic (3.51 ± 0.38 m/s) in all volunteers (p < 0.0001). In HCM patients, SW velocity correlated with E/e' ratio (r = 0.346, p = 0.04 for aortic SW and r = 0.667, p = 0.04 for mitral SW). A subgroup of 20 volunteers were matched for age and gender to 20 HCM patients. In HCM, the mean velocity of 5.1 ± 0.7 m/s for the aortic SW (3.61 ± 0.46 m/s in matched volunteers, p < 0.0001) and 6.88 ± 1.12 m/s for the mitral SW(4.65 ± 0.77 m/s in matched volunteers, p < 0.0001). A threshold of 4 m/s for the aortic SW correctly classified pathologic myocardium with a sensitivity of 95% and specificity of 90%. Naturally occurring SW can be used to assess differences between normal and pathologic myocardium.
我们应用高帧率（超过 500 Hz）组织多普勒方法来测量主动脉瓣和二尖瓣关闭时产生的自然传播剪切波（SW）的传播速度。本研究旨在证明其临床相关性。我们纳入了 45 名健康志愿者和 43 名肥厚型心肌病（HCM）患者。所有志愿者的二尖瓣 SW（4.68±0.66 m/s）均显著快于主动脉瓣 SW（3.51±0.38 m/s）（p<0.0001）。在 HCM 患者中，SW 速度与 E/e' 比值相关（主动脉瓣 SW：r=0.346，p=0.04；二尖瓣 SW：r=0.667，p=0.04）。20 名志愿者与 20 名 HCM 患者按年龄和性别匹配。在 HCM 患者中，主动脉瓣 SW 的平均速度为 5.1±0.7 m/s（匹配志愿者为 3.61±0.46 m/s，p<0.0001），二尖瓣 SW 为 6.88±1.12 m/s（匹配志愿者为 4.65±0.77 m/s，p<0.0001）。主动脉瓣 SW 的 4 m/s 阈值可正确分类病理性心肌，其灵敏度为 95%，特异性为 90%。自然发生的 SW 可用于评估正常和病理性心肌之间的差异。
