Wilkenshoff U M, Sovany A, Wigström L, Olstad B, Lindström L, Engvall J, Janerot-Sjöberg B, Wranne B, Hatle L, Sutherland G R
Norwegian Institute of Technology, Trondheim.
J Am Soc Echocardiogr. 1998 Jul;11(7):683-92. doi: 10.1053/je.1998.v11.a90584.
A new color Doppler myocardial imaging (CDMI) system with high spatial and temporal resolution and novel postprocessing modalities has been developed that could allow quantifiable stress echocardiography. The purpose of this study was to determine whether regional myocardial systolic velocities could be accurately and reproducibly measured both at rest and during bicycle ergometry by using CDMI. Thirty normal subjects were examined with CDMI at rest, and peak mean systolic myocardial velocities (MSV) were measured for 34 predetermined left ventricular myocardial segments. Interobserver variability and intraobserver variability were established for all segments. Submaximal bicycle ergometry was performed in 20 normal subjects by using standardized weight-related increases in workload. MSV were measured at each step of exercise for 16 left ventricular stress echo segments. At rest, a base-apex gradient in regional MSV was recorded with highest longitudinal shortening velocities at the base. A similar pattern was noted for circumferential shortening MSV. Measurements were predictable and highly reproducible with low interobserver and intraobserver variability for 26 of 34 segments. Reproducibility was poor for basal anteroseptal segments in all views and mid anterior, anteroseptal, and septal segments in the short-axis views. During exercise, mid and basal segments of all walls showed a significant increase of MSV between each workload step and for apical segments between alternate steps. The resting base-apex velocity gradient observed at rest remained in all walls throughout ergometry. Thus a CDMI system with improved spatial and temporal resolution and postprocessing analysis modalities provided reproducible and accurate quantification of segmental left ventricular circumferential and longitudinal contraction both at rest and during exercise.
一种具有高空间和时间分辨率以及新型后处理模式的新型彩色多普勒心肌成像（CDMI）系统已被开发出来，它可能实现可量化的负荷超声心动图检查。本研究的目的是确定使用CDMI能否在静息状态和自行车运动试验期间准确且可重复地测量局部心肌收缩速度。对30名正常受试者进行静息状态下的CDMI检查，测量34个预先确定的左心室心肌节段的平均收缩期心肌峰值速度（MSV）。确定了所有节段的观察者间变异性和观察者内变异性。20名正常受试者通过使用与体重相关的标准化工作量增加进行次极量自行车运动试验。在运动的每个阶段测量16个左心室负荷超声心动图节段的MSV。静息状态下，记录到局部MSV存在从心底到心尖的梯度，心底处纵向缩短速度最高。圆周缩短MSV也观察到类似模式。34个节段中有26个节段的测量结果具有可预测性且高度可重复，观察者间和观察者内变异性低。所有视图中的基底前间隔节段以及短轴视图中的中间前壁、前间隔和间隔节段的可重复性较差。运动期间，所有壁的中间和基底节段在每个工作量阶段之间以及心尖节段在交替阶段之间的MSV均显著增加。在整个运动试验过程中，所有壁在静息状态下观察到的心底到心尖速度梯度仍然存在。因此，一种具有改进的空间和时间分辨率以及后处理分析模式的CDMI系统能够在静息状态和运动期间对左心室节段圆周和纵向收缩进行可重复且准确的量化。
