Bojö L, Wandt B, Ahlin N G
Department of Clinical Physiology Central Hospital, Karlstad, Sweden.
Clin Physiol. 1998 May;18(3):195-201. doi: 10.1046/j.1365-2281.1998.00093.x.
Diastolic left ventricular function is usually described using Doppler recording of the early to atrial (E/A) ratio. However, because of pseudonormalization in patients with moderately impaired diastolic function, the E/A ratio does not allow a meaningful comparison between a group of patients with varying degrees of dysfunction, e.g. after acute myocardial infarction (AMI), and a group of healthy control subjects. In this study, diastolic function was assessed using the E/A ratio, deceleration time of early mitral inflow and maximal longitudinal relaxation velocity. The relaxation velocity was measured using echocardiographic M-mode recording of mitral annulus motion. Mitral annulus motion was recorded in four- and two-chamber views. Relaxation velocities were measured in the septal, lateral, anterior and posterior parts of the mitral annulus and the mean value (RVm) was calculated. Twenty-two consecutive patients were investigated 3-21 days after first transmural AMI. Twenty-two healthy subjects of similar age served as a control group. The group of patients with AMI had an RVm of 40.9 +/- 15.4 mm s-1 compared with 68.5 +/- 12.4 mm s-1 in the control group (P < 0.0001). In contrast, the E/A ratio, deceleration time and heart rate did not differ significantly between the two groups. The results suggest that maximal longitudinal relaxation velocity is a simple and appropriate measure of diastolic function in patients with transmural AMI.
左心室舒张功能通常采用早期至心房（E/A）比值的多普勒记录来描述。然而，由于舒张功能中度受损患者存在假性正常化，E/A比值无法对不同程度功能障碍的患者组（如急性心肌梗死（AMI）后）与健康对照组进行有意义的比较。在本研究中，使用E/A比值、二尖瓣早期血流减速时间和最大纵向松弛速度来评估舒张功能。使用二尖瓣环运动的超声心动图M型记录来测量松弛速度。在四腔心和两腔心视图中记录二尖瓣环运动。在二尖瓣环的间隔、外侧、前侧和后侧部分测量松弛速度，并计算平均值（RVm）。对22例首次透壁性AMI后3 - 21天的连续患者进行了研究。22名年龄相仿的健康受试者作为对照组。AMI患者组的RVm为40.9±15.4 mm/s，而对照组为68.5±12.4 mm/s（P < 0.0001）。相比之下，两组之间的E/A比值、减速时间和心率没有显著差异。结果表明，最大纵向松弛速度是透壁性AMI患者舒张功能的一种简单且合适的测量指标。
