Sheehan F H, Bolson E L, Dodge H T, Mathey D G, Schofer J, Woo H W
Circulation. 1986 Aug;74(2):293-305. doi: 10.1161/01.cir.74.2.293.
We sought to identify theoretical advantages and applications of the centerline method for quantitative assessment of regional ventricular function. Motion was measured along 100 chords constructed perpendicular to a centerline drawn midway between the end-diastolic and end-systolic contours, and normalized for heart size. Abnormality was expressed in units of standard deviations from the mean motion in a normal reference population to indicate both the severity and significance of the wall motion abnormality. The mean abnormality averaged over 100 chords correlated highly with the area ejection fraction (r = .97). The centerline method uses a "sliding window" to measure motion where it is abnormal, because assessment of wall motion in predefined regions of the ventricular contour underestimates abnormality. From the 100 data points, the extent (% of contour) of regional abnormalities can also be determined. The severity of hypokinesis at the site of acute myocardial infarction correlated better with infarct size estimated from creatine kinase release (r = -.78) than did the ejection fraction or the circumferential extent of hypokinesis. Because the centerline method measures motion along locally determined vectors, and requires no apex, origin, coordinate system, or geometric reference figure, it can be applied to contours as dissimilar as the 60 degree left anterior oblique projection of the left ventricle and the 75 degree left anterior oblique projection of the right ventricle.
我们试图确定中心线法在定量评估局部心室功能方面的理论优势及应用。沿着与在舒张末期和收缩末期轮廓之间中点所画中心线垂直的100条弦测量运动，并根据心脏大小进行归一化。异常情况以与正常参考人群平均运动的标准差单位表示，以表明壁运动异常的严重程度和显著性。100条弦上的平均异常情况与面积射血分数高度相关（r = 0.97）。中心线法使用“滑动窗口”来测量异常部位的运动，因为在心室轮廓预定义区域评估壁运动会低估异常情况。从这100个数据点，还可以确定局部异常的范围（轮廓的百分比）。急性心肌梗死部位运动减弱的严重程度与根据肌酸激酶释放估计的梗死面积相关性更好（r = -0.78），优于射血分数或运动减弱的圆周范围。由于中心线法沿着局部确定的向量测量运动，且不需要顶点、原点、坐标系或几何参考图形，所以它可应用于像左心室60度左前斜位投影和右心室75度左前斜位投影这样不同的轮廓。
