Gulati V K, Katz W E, Follansbee W P, Gorcsan J
Division of Cardiology, University of Pittsburgh, Pennsylvania 15213, USA.
Am J Cardiol. 1996 May 1;77(11):979-84. doi: 10.1016/s0002-9149(96)00033-1.
Mitral annular descent has been described as an index of left ventricular (LV) systolic function, which is independent of endocardial definition. Echocardiographic tissue Doppler imaging is a new technique that calculates and displays color-coded cardiac tissue velocities on-line. To evaluate mitral annular descent velocity as a rapid index of global LV function, we performed tissue Doppler imaging studies in 55 patients, aged 56 +/-15 years, within 3 hours of radionuclide ventriculographic ejection fraction. Tissue Doppler M-mode studies were obtained from each of 6 mitral annular sites, as follows: inferoseptal and lateral from apical 4-chamber views, anterior and inferior from apical 2-chamber views, and anteroseptal and posterior from apical long-axis views. Only 1 patient with severe mitral annular calcification was excluded. The group mean 6-site average peak mitral annular descent velocity was 5.5 +/- 1.9 cm/s (range 2.4 to 10.5), and the group mean ejection fraction was 49 +/- 18% (range 17 to 80%). The 6-site average peak annular descent velocity correlated linearly with LV ejection fraction (r = 0.86, SEE = 1.02 cm/s): LV ejection fraction = 8.2 (average peak mitral annular descent velocity) + 3%. The 6-site peak mitral annular descent velocity average >5.4 cm/s was 88% sensitive and 97% specific for ejection fraction >50%. The peak mitral annular descent velocity from the apical 4-chamber view (average from inferoseptal and lateral sites) correlated most closely with the LV ejection fraction (r = 0.85) as an individual view. Peak mitral annular descent velocity by tissue Doppler imaging has the potential to estimate rapidly the global LV function.
二尖瓣环下移已被描述为左心室（LV）收缩功能的一个指标，它与心内膜的清晰度无关。超声心动图组织多普勒成像技术是一种可在线计算并显示彩色编码心脏组织速度的新技术。为了评估二尖瓣环下移速度作为左心室整体功能的快速指标，我们对55例年龄为56±15岁的患者在放射性核素心室造影射血分数测定后3小时内进行了组织多普勒成像研究。从6个二尖瓣环部位分别获取组织多普勒M型图像，具体如下：从心尖四腔心切面获取下间隔和侧壁部位图像，从心尖两腔心切面获取前壁和下壁部位图像，从心尖长轴切面获取前间隔和后壁部位图像。仅排除1例重度二尖瓣环钙化患者。该组6个部位平均二尖瓣环下移峰值速度为5.5±1.9cm/s（范围2.4至10.5），组平均射血分数为49±18%（范围17至80%）。6个部位平均二尖瓣环下移峰值速度与左心室射血分数呈线性相关（r = 0.86，标准误=1.02cm/s）：左心室射血分数 = 8.2（二尖瓣环下移平均峰值速度）+ 3%。6个部位二尖瓣环下移峰值速度平均>5.4cm/s对射血分数>50%的敏感性为88%，特异性为97%。作为单个切面，从心尖四腔心切面（下间隔和侧壁部位的平均值）测得的二尖瓣环下移峰值速度与左心室射血分数相关性最为密切（r = 0.85）。通过组织多普勒成像测得的二尖瓣环下移峰值速度有可能快速评估左心室整体功能。
