Palka P, Lange A, Fleming A D, Fenn L N, Bouki K P, Shaw T R, Fox K A, McDicken W N, Sutherland G R
Department of Cardiology, Western General Hospital, Edinburgh, Scotland, U.K.
Eur Heart J. 1996 Jun;17(6):940-50. doi: 10.1093/oxfordjournals.eurheartj.a014977.
Doppler myocardial imaging is a new cardiac ultrasound technique based on the principles of colour Doppler imaging which can determine myocardial velocities by detecting the changes of phase-shift of the ultrasound signal returning directly from the myocardium. To determine the normal range of transmural velocities in healthy hearts a prospective study was carried out involving 42 normal subjects (age from 21 to 78, mean 47 +/- 16 years). Using M-mode Doppler myocardial imaging the peak values of the mean velocity and velocity gradient across the left ventricular posterior wall were measured during standardized phases of the cardiac cycle. Peak mean velocities had the following values during the cardiac cycle: isovolumic contraction - 1.3 +/- 1.2 cm. s-1, early ventricular ejection 4.2 +/- 1.2 cm. s-1, late ventricular ejection 1.8 +/- 1.1 cm. s-1, isovolumic relaxation -2.0 +/- 0.8 cm. s-1, rapid ventricular filling -6.6 +/- 2.2 cm. s-1, atrial contraction -2.8 +/- 1.8 cm. s-1, atrial relaxation 1.2 +/- 1.1 cm. s-1. Peak velocity gradients were: isovolumic contraction 1.3 +/- 1.9 s-1, early ventricular contraction 4.7 +/- 1.9 s-1, late ventricular contraction 1.1 +/- 1.0 s-1, isovolumic relaxation -0.6 +/- 0.5 s-1, rapid ventricular filling 6.1 +/- 3.4 s-1, atrial contraction 2.6 +/- 1.7 s-1, atrial relaxation 0.0 +/- 0.3 s-1. Linear regression analysis showed that with the increase of age, peak velocity gradient decreases during rapid ventricular filling (r = 0.83; P < 0.0001) and increases during atrial contraction (r = 0.86; P < 0.0001) while peak mean velocity increases only during atrial contraction (r = 0.80, P < 0.0001). Thus, there was no correlation between increasing age and systolic peak mean velocity and peak velocity gradient but both diastolic filling phases rapid ventricular filling and atrial contraction demonstrated age-related changes. In summary, this study has determined the age-related range of normal transmural myocardial velocities within the left ventricular posterior wall in healthy hearts during the cardiac cycle. We conclude that these measurements of peak mean velocities and peak velocity gradients, should form the baseline for subsequent Doppler myocardial imaging clinical studies on myocardial diseases processes.
多普勒心肌成像技术是一种基于彩色多普勒成像原理的新型心脏超声技术，它通过检测直接从心肌返回的超声信号的相移变化来测定心肌速度。为确定健康心脏透壁速度的正常范围，开展了一项前瞻性研究，纳入42名正常受试者（年龄21至78岁，平均47±16岁）。使用M型多普勒心肌成像技术，在心动周期的标准化阶段测量左心室后壁平均速度和速度梯度的峰值。心动周期中平均峰值速度如下：等容收缩期-1.3±1.2厘米·秒⁻¹，心室早期射血期4.2±1.2厘米·秒⁻¹，心室晚期射血期1.8±1.1厘米·秒⁻¹，等容舒张期-2.0±0.8厘米·秒⁻¹，心室快速充盈期-6.6±2.2厘米·秒⁻¹，心房收缩期-2.8±1.8厘米·秒⁻¹，心房舒张期1.2±1.1厘米·秒⁻¹。峰值速度梯度如下：等容收缩期1.3±1.9秒⁻¹，心室早期收缩期4.7±1.9秒⁻¹，心室晚期收缩期1.1±1.0秒⁻¹，等容舒张期-0.6±0.5秒⁻¹，心室快速充盈期6.1±3.4秒⁻¹，心房收缩期2.6±1.7秒⁻¹，心房舒张期0.0±0.3秒⁻¹。线性回归分析显示，随着年龄增长，心室快速充盈期峰值速度梯度降低（r = 0.83；P < 0.0001），心房收缩期增加（r = 0.86；P < 0.0001），而平均峰值速度仅在心房收缩期增加（r = 0.80，P < 0.0001）。因此，年龄增长与收缩期平均峰值速度和峰值速度梯度之间无相关性，但舒张期充盈阶段心室快速充盈期和心房收缩期均显示出与年龄相关的变化。总之，本研究确定了健康心脏心动周期中左心室后壁正常透壁心肌速度的年龄相关范围。我们得出结论，这些平均峰值速度和峰值速度梯度的测量结果应作为后续关于心肌疾病过程的多普勒心肌成像临床研究的基线。
