Godoy I E, Mor-Avi V, Weinert L, Vignon P, Korcarz C, Spencer K T, Lang R M
Department of Medicine, University of Chicago, Illinois, USA.
J Am Coll Cardiol. 1998 Jun;31(7):1598-606. doi: 10.1016/s0735-1097(98)00144-2.
We tested the feasibility of using analysis of color kinesis images to objectively assess global and regional left ventricular (LV) diastolic function in patients with dilated cardiomyopathy (DCM). In addition, the ability of this technique to track drug-induced changes on LV diastolic properties was studied.
Diastolic dysfunction contributes to symptomatology in patients with DCM. The assessment of LV diastolic function using conventional Doppler echocardiography is indirect and is confounded by multiple variables. Moreover, the noninvasive evaluation of regional diastolic properties is difficult. In contrast, color kinesis directly tracks and color-encodes regional diastolic endocardial motion.
We studied 24 patients with DCM and mitral regurgitation (MR) and 24 age-matched normal subjects. Transmitral and pulmonary vein flow velocities were measured using pulsed Doppler echocardiography. Diastolic color kinesis images were used to calculate indexes of magnitude and timing of global and regional diastolic function. Diastolic asynchrony was evaluated in different subgroups of patients with DCM. The effects of drug infusions (nitroprusside and dobutamine) were also studied.
Color kinesis indexes of global diastolic function showed significant differences between patients with DCM and normal subjects. Compared with Doppler indexes, color kinesis was less confounded by MR and was capable of differentiating between drug-induced lusitropic and vasodilator effects. Diastolic asynchrony was increased in patients with DCM and severe MR.
Quantitative analysis of global and regional LV diastolic function in patients with DCM using color kinesis is feasible.
我们测试了利用彩色室壁运动分析图像客观评估扩张型心肌病（DCM）患者左心室（LV）整体和局部舒张功能的可行性。此外，还研究了该技术追踪药物引起的LV舒张特性变化的能力。
舒张功能障碍导致DCM患者出现症状。使用传统多普勒超声心动图评估LV舒张功能是间接的，且受多个变量的影响。此外，局部舒张特性的无创评估也很困难。相比之下，彩色室壁运动直接追踪并对局部舒张期心内膜运动进行彩色编码。
我们研究了24例患有DCM和二尖瓣反流（MR）的患者以及24例年龄匹配的正常受试者。使用脉冲多普勒超声心动图测量二尖瓣和肺静脉血流速度。舒张期彩色室壁运动图像用于计算整体和局部舒张功能的幅度和时间指标。对DCM患者的不同亚组评估舒张不同步情况。还研究了药物输注（硝普钠和多巴酚丁胺）的效果。
DCM患者和正常受试者之间的整体舒张功能彩色室壁运动指标存在显著差异。与多普勒指标相比，彩色室壁运动受MR的影响较小，并且能够区分药物引起的舒张期松弛和血管扩张作用。DCM和严重MR患者的舒张不同步增加。
使用彩色室壁运动对DCM患者的LV整体和局部舒张功能进行定量分析是可行的。
