Sousa M J, Cotrim C, Nunes H, Valério L, Soares R M, Abreu J, Bernardes L, Salomão S, Rato J A
Serviço de Cardiologia, Hospital de Santa Marta, Lisboa.
Rev Port Cardiol. 1994 May;13(5):405-15, 380.
Left ventricular ejection force as been purpose as a new Doppler ejection phase index, to assess left ventricular performance. In order to evaluate its usefulness, 33 patients undergoing cardiac catheterization were prospectively study. We considered three groups based on angiographic ejection fraction: group A-- > or = 55% (11 patients), group B--35 to 55% (10 patients), and group C-- < or = 35% (10 patients). All patients were in sinus rhythm and mitral regurgitation > I/IV or aortic valve disease were exclusion criterion. The following parameters, derived from Pulsed Doppler aortic velocities curves, were analyzed: peak velocity (cm/s), acceleration time (s), velocity time integral over the acceleration time (VTI Ac-cm), mean acceleration (cm/s2) and ejection force (g.cm/s2). Ejection force as calculated using the mass-acceleration concept, ad: ejection force = mean acceleration x VTI Ac x CsA x 1.06 (CsA - 2D cross sectional area of the aortic annulus; 1.06 - mass density of blood, g/cm3). [table: see text]
The present study confirms that Doppler echocardiography can be used for the assessment of left ventricular performance based on noninvasive measurements and that Doppler derived ejection force is an accurate index for this purpose. However, ejection force evaluation, taking in account the results obtained for mean acceleration, a much less time consuming Doppler derived parameter, appears not to show any clinical advantage.
左心室射血力已被用作一种新的多普勒射血期指标,以评估左心室功能。为了评估其效用,对33例接受心导管检查的患者进行了前瞻性研究。根据血管造影射血分数,我们将患者分为三组:A组——射血分数≥55%(11例患者),B组——射血分数35%至55%(10例患者),C组——射血分数≤35%(10例患者)。所有患者均为窦性心律,二尖瓣反流>Ⅰ/Ⅳ级或主动脉瓣疾病为排除标准。分析了从脉冲多普勒主动脉速度曲线得出的以下参数:峰值速度(cm/s)、加速时间(s)、加速时间内的速度时间积分(VTI Ac-cm)、平均加速度(cm/s²)和射血力(g.cm/s²)。射血力使用质量-加速度概念计算,即:射血力=平均加速度×VTI Ac×CsA×1.06(CsA——主动脉瓣环的二维横截面积;1.06——血液的质量密度,g/cm³)。[表:见正文]
本研究证实,多普勒超声心动图可用于基于无创测量评估左心室功能,且多普勒得出的射血力是用于此目的的准确指标。然而,考虑到平均加速度(一个耗时少得多的多普勒得出的参数)所获得的结果,射血力评估似乎并未显示出任何临床优势。