Kurokawa S, Okuri H, Sasaoka T, Machida Y, Osada K, Kikawada R
Department of Internal Medicine, Kitasato University School of Medicine, Sagamihara, Japan.
Jpn Heart J. 1998 Jul;39(4):489-501. doi: 10.1536/ihj.39.489.
We devised a pulsed Doppler echocardiographic method of separately calculating early diastolic filling volume (EDFV) and late diastolic filling volume during atrial contraction (LDFV) and observed a relationship between diastolic filling volume and velocity in thirty patients with coronary artery disease. By analysing the transmitral flow velocity curve and mitral valve motion, EDFV and LDFV were measured on the basis of the equality of left ventricular inflow and outflow volumes. The Doppler-determined EDFV and LDFV correlated well with those obtained from the left ventricular filling curve produced by left ventriculography. Angiographic EDFV and LDFV were measured from the time (t)-volume (V) curve, using the t-dV/dt curve to define early and late diastolic phases. A good correlation was found between Doppler and angiographic EDFV (y = -3.0 + 1.0 x, r = 0.98, p = 0.0001, n = 20), Doppler and angiographic LDFV (y = 1.6 + 1.0 x, r = 0.86, p = 0.0001), and also between Doppler and angiographic EDFV/LDFV (y = 0.05 + 0.9 x, r = 0.93, p = 0.0001). EDFV and the peak early diastolic filling velocity were significantly correlated (E velocity; y = 25 + 0.51 x, r = 0.48, p = 0.0068), while LDFV and the peak late diastolic filling velocity during atrial contraction (A velocity) were not. Our results validate the method of calculating EDFV and LDFV separately and suggest that early diastole in the left ventricle has flow volume dependency, but that the late diastole filling velocity during atrial contraction may be regulated by other factors such as increased left atrial contraction.
我们设计了一种脉冲多普勒超声心动图方法，用于分别计算舒张早期充盈量（EDFV）和心房收缩期的舒张晚期充盈量（LDFV），并观察了30例冠心病患者舒张期充盈量与速度之间的关系。通过分析二尖瓣血流速度曲线和二尖瓣运动，基于左心室流入和流出量相等来测量EDFV和LDFV。多普勒测定的EDFV和LDFV与左心室造影产生的左心室充盈曲线所获得的结果相关性良好。血管造影的EDFV和LDFV是从时间（t）-容积（V）曲线测量的，使用t-dV/dt曲线来定义舒张早期和晚期阶段。在多普勒与血管造影的EDFV（y = -3.0 + 1.0x，r = 0.98，p = 0.0001，n = 20）、多普勒与血管造影的LDFV（y = 1.6 + 1.0x，r = 0.86，p = 0.0001）之间，以及多普勒与血管造影的EDFV/LDFV（y = 0.05 + 0.9x，r = 0.93，p = 0.0001）之间均发现了良好的相关性。EDFV与舒张早期充盈峰值速度显著相关（E速度；y = 25 + 0.51x，r = 0.48，p = 0.0068），而LDFV与心房收缩期舒张晚期充盈峰值速度（A速度）则无相关性。我们的结果验证了分别计算EDFV和LDFV的方法，并表明左心室舒张早期具有流量依赖性，但心房收缩期舒张晚期充盈速度可能受其他因素调节，如左心房收缩增强。
