Vignon P, Mor-Avi V, Weinert L, Koch R, Spencer K T, Lang R M
Department of Medicine, The University of Chicago Medical Center, Ill 60637, USA.
Circulation. 1998 Mar 24;97(11):1053-61. doi: 10.1161/01.cir.97.11.1053.
Diastolic wall motion asynchrony is a major determinant of impaired left ventricular (LV) filling in patients with concentric hypertrophy and coronary artery disease. We evaluated the ability of Color Kinesis, a new echocardiographic technique that color-encodes endocardial motion, to quantitatively assess global and regional LV filling properties.
Color Kinesis images and mitral and pulmonary vein flow Doppler data were acquired in 29 patients with LV hypertrophy and 29 age-matched control subjects. In addition, Color Kinesis data were correlated to coronary angiographic findings in 15 patients with suspected coronary artery disease. Segmental analysis of Color Kinesis images was used to obtain time histograms of regional diastolic fractional area change, wherein early and late peaks (peaks 1 and 2) reflected rapid LV filling and atrial contraction, respectively. Regional mean LV filling time and filling curves were used to objectively identify diastolic endocardial motion asynchrony in patients with LV hypertrophy and coronary artery disease. None of the mitral and pulmonary vein Doppler indices differentiated patients with normalized mitral Doppler profile (n=13) from control subjects, whereas reduced peak1/peak2 ratio and prolonged mean filling time indicated augmented contribution of atrial contraction toward LV filling (P<.05). In 22 of 25 patients with LV hypertrophy and preserved systolic function and in all patients with coronary artery disease, delayed diastolic endocardial motion was observed in at least one segment.
Analysis of Color Kinesis images provides objective assessment of global and regional LV filling properties and allows identification of both diastolic dysfunction in patients with normalized Doppler indices and wall motion asynchrony.
舒张期室壁运动不同步是导致同心性肥厚和冠状动脉疾病患者左心室（LV）充盈受损的主要决定因素。我们评估了彩色室壁运动分析技术（一种对心内膜运动进行彩色编码的新型超声心动图技术）定量评估左心室整体和局部充盈特性的能力。
对29例左心室肥厚患者和29例年龄匹配的对照者采集了彩色室壁运动分析图像以及二尖瓣和肺静脉血流多普勒数据。此外，对15例疑似冠状动脉疾病患者的彩色室壁运动分析数据与冠状动脉造影结果进行了相关性分析。采用彩色室壁运动分析图像的节段分析获取局部舒张期面积变化分数的时间直方图，其中早期和晚期峰值（峰值1和峰值2）分别反映左心室快速充盈和心房收缩。采用局部平均左心室充盈时间和充盈曲线客观识别左心室肥厚和冠状动脉疾病患者的舒张期心内膜运动不同步。二尖瓣和肺静脉多普勒指标均无法区分二尖瓣多普勒形态正常的患者（n = 13）与对照者，而峰值1/峰值2比值降低和平均充盈时间延长表明心房收缩对左心室充盈的贡献增加（P <.05）。在25例左心室肥厚且收缩功能正常的患者中有22例以及所有冠状动脉疾病患者中，至少在一个节段观察到舒张期心内膜运动延迟。
彩色室壁运动分析图像分析可对左心室整体和局部充盈特性进行客观评估，并能识别多普勒指标正常患者的舒张功能障碍以及室壁运动不同步。
