Daley P J, Sagar K B, Collier B D, Kalbfleisch J, Wann L S
Department of Medicine, Medical College of Wisconsin, Milwaukee 53226.
Br Heart J. 1987 Nov;58(5):447-54. doi: 10.1136/hrt.58.5.447.
A study was performed to test the hypothesis that Doppler echocardiographic measurement of ascending aortic blood flow can detect exercise induced changes in left ventricular performance during exercise in patients suspected of having ischaemic heart disease. Acceleration and peak velocity of flow and stroke volume were determined by non-imaging Doppler echocardiography in the suprasternal notch in 38 patients as they underwent simultaneous exercise radionuclide ventriculography. The patients were divided into four groups: group 1 had resting ejection fractions greater than or equal to 50% and increased their ejection fractions greater than or equal to 5% during exercise; group 2 had resting ejection fractions of greater than or equal to 50% but the ejection fraction either fell or rose less than 5% during exercise; group 3 had resting ejection fractions less than 50% but the ejection fraction rose greater than or equal to 5% during exercise; and group 4 had resting ejection fractions less than 50% and the exercise ejection fraction either fell or rose less than 5% during exercise. Acceleration, velocity, and stroke volume all rose significantly during exercise in group 1. Acceleration also increased in group 2 but to a lesser extent; velocity and stroke volume did not increase. In group 3 acceleration and velocity increased but to a lesser extent than in group 1; stroke volume did not increase. In group 4 velocity increased slightly during exercise but acceleration and stroke volume were unchanged. Doppler echocardiography thus appears capable of detecting exercise induced changes in left ventricular performance and can identify normal and abnormal responses, as defined by radionuclide ventriculography.
对于疑似患有缺血性心脏病的患者，通过多普勒超声心动图测量升主动脉血流，能够检测出运动过程中左心室功能的变化。在38例患者进行同步运动放射性核素心室造影时，通过胸骨上切迹处的非成像多普勒超声心动图测定血流加速度、峰值流速和每搏输出量。患者被分为四组：第1组静息射血分数大于或等于50%，运动期间射血分数增加大于或等于5%；第2组静息射血分数大于或等于50%，但运动期间射血分数下降或上升幅度小于5%；第3组静息射血分数小于50%，但运动期间射血分数上升大于或等于5%；第4组静息射血分数小于50%，且运动期间射血分数下降或上升幅度小于5%。第1组运动期间加速度、流速和每搏输出量均显著增加。第2组加速度也增加，但幅度较小；流速和每搏输出量未增加。第3组加速度和流速增加，但幅度小于第1组；每搏输出量未增加。第4组运动期间流速略有增加，但加速度和每搏输出量未改变。因此，多普勒超声心动图似乎能够检测出运动引起的左心室功能变化，并能识别出放射性核素心室造影所定义的正常和异常反应。
