Pai R G, Buech G C
Pettis V.A. Medical Center, Loma Linda, California, USA.
Clin Cardiol. 1996 Apr;19(4):277-88. doi: 10.1002/clc.4960190402.
Left ventricular (LV) diastolic dysfunction is an important cause of heart failure, and recent advances in the application of Doppler techniques allow a semiquantitative assessment of LV diastolic performance. This review discusses the use of Doppler echocardiography in the comprehensive assessment of LV diastolic function and performance in terms of the normal mitral and pulmonary venous flow profiles, their physiologic basis, and alterations in diseased states. There is also a discussion on the newer aspects of mitral flows such as relative durations of mitral A and pulmonary vein AR waves, E- and A- wave propagation inside the LV with their hemodynamic correlates, and derivation of ventricular dP/dt and Tau from the mitral regurgitation velocity profile. Analysis of these flow profiles and the other Doppler measures alluded to above allow one to make a fairly precise hemodynamic assessment of a patient in terms of left atrial pressure, LV relaxation and stiffness and the profile of LV diastolic pressure in terms of pre- 'a' wave and 'a' wave pressures and ventricular end-diastolic pressure.
左心室舒张功能障碍是心力衰竭的重要原因，近年来多普勒技术应用的进展使得能够对左心室舒张功能进行半定量评估。本综述从正常二尖瓣和肺静脉血流频谱、其生理基础以及疾病状态下的改变等方面，讨论了多普勒超声心动图在左心室舒张功能和性能综合评估中的应用。还讨论了二尖瓣血流的新方面，如二尖瓣A波和肺静脉AR波的相对持续时间、E波和A波在左心室内的传播及其血流动力学相关性，以及从二尖瓣反流速度频谱推导心室dP/dt和Tau。对这些血流频谱以及上述其他多普勒测量指标的分析，有助于根据左心房压力、左心室舒张和僵硬度以及左心室舒张压力曲线（根据“a”波前压力、“a”波压力和心室舒张末期压力）对患者进行相当精确的血流动力学评估。
