Kuroiwa N, Nakamura K, Kawagoe H, Kawahira M, Sanada J, Hashimoto S
Second Department of Internal Medicine, Faculty of Medicine, Kagoshima University.
J Cardiogr. 1986 Sep;16(3):649-58.
There is no noninvasive index to assess the left ventricular relaxation property during the isovolumic relaxation period except for the isovolumic relaxation time, which is derived from M-mode echocardiography or phonocardiography. The intracardiac blood flow can now be precisely observed using pulsed Doppler echocardiography. We evaluated the left ventricular relaxation property and studied the effect of age on the relaxation property using this method. Cardiac catheterization and pulsed Doppler echocardiography were performed for 27 patients with various heart diseases, none of whom had wall motion abnormalities on left ventriculography, to determine the relationships between invasive and noninvasive parameters. The effects of age were examined in 25 normal healthy persons ranging in age from 26 to 69 years. In all cases, the intracardiac blood flow during the isovolumic relaxation period (isovolumic relaxation flow) as obtained by pulsed Doppler echocardiography was laminar, and directed from the base toward the apex of the left ventricle. The duration of this flow (the time interval from the beginning to the end of this flow; IRT), the acceleration time (the time interval from the beginning to the peak velocity; ACT) and the acceleration rate (the slope of the beginning to the peak velocity; AcR) were measured, and IRT, ln AcT (natural logarithm of AcT) and ln AcR (natural logarithm of AcR) were compared with the parameters obtained by cardiac catheterization. The time constant T of the fall in left ventricular pressure during the isovolumic relaxation period, which was proposed as an index of the left ventricular relaxation property, correlated well with IRT (r = 0.82, p less than 0.001), ln AcT (r = 0.69, p less than 0.001) and ln AcR (r = -0.77, p less than 0.001), but there were no significant correlations with maximum blood pressure, left ventricular ejection fraction, maximal positive dp/dt or the left ventricular end-diastolic volume index. Age and these three Doppler indexes in normal healthy persons correlated significantly as follows; IRT (r = 0.80, p less than 0.001), ln AcT (r = 0.60, p less than 0.001) and ln AcR (r = -0.61, p less than 0.01).(ABSTRACT TRUNCATED AT 400 WORDS)
除了从M型超声心动图或心音图得出的等容舒张时间外，没有其他无创指标可用于评估等容舒张期的左心室舒张特性。目前，使用脉冲多普勒超声心动图可以精确观察心腔内血流情况。我们采用该方法评估左心室舒张特性，并研究年龄对舒张特性的影响。对27例患有各种心脏病且左心室造影无室壁运动异常的患者进行了心导管检查和脉冲多普勒超声心动图检查，以确定有创和无创参数之间的关系。在25名年龄范围为26至69岁的正常健康人中研究了年龄的影响。在所有病例中，脉冲多普勒超声心动图获得的等容舒张期心腔内血流（等容舒张期血流）呈层流，且从左心室基部指向心尖。测量了该血流的持续时间（从血流开始到结束的时间间隔；IRT）、加速时间（从血流开始到峰值速度的时间间隔；ACT）和加速率（从血流开始到峰值速度的斜率；AcR），并将IRT、ln AcT（AcT的自然对数）和ln AcR（AcR的自然对数）与心导管检查获得的参数进行比较。等容舒张期左心室压力下降的时间常数T被提议作为左心室舒张特性的指标，它与IRT（r = 0.82，p < 0.001）、ln AcT（r = 0.69，p < 0.001）和ln AcR（r = -0.77，p < 0.001）相关性良好，但与最高血压、左心室射血分数、最大正dp/dt或左心室舒张末期容积指数无显著相关性。正常健康人的年龄与这三个多普勒指标有显著相关性，具体如下：IRT（r = 0.80，p < 0.001）、ln AcT（r = 0.60，p < 0.001）和ln AcR（r = -0.61，p < 0.01）。（摘要截断于400字）
