NONINVASIVE MEASUREMENT OF RATE OF LEFT-VENTRICULAR RELAXATION BY DOPPLER-ECHOCARDIOGRAPHY - VALIDATION WITH SIMULTANEOUS CARDIAC-CATHETERIZATION
NONINVASIVE MEASUREMENT OF RATE OF LEFT-VENTRICULAR RELAXATION BY DOPPLER-ECHOCARDIOGRAPHY - VALIDATION WITH SIMULTANEOUS CARDIAC-CATHETERIZATION
复制标题
DOI：
10.1161/01.cir.88.1.146
复制
发表时间：
1993-07-01
期刊：
影响因子：
37.8
通讯作者：
HOLMES, DR
中科院分区：
文献类型：
--
作者：
NISHIMURA, RA;SCHWARTZ, RS;HOLMES, DR
背景。收缩期左心室和左心房之间的瞬时压力梯度可通过二尖瓣反流多普勒速度曲线计算得出。我们研究的目的是通过将从多普勒二尖瓣反流信号得出的松弛时间常数（TAU）与人体同时进行的高保真左心室压力测量结果进行比较，来确定其测量的准确性。
方法与结果。25名患者在进行高保真左心室压力测量的同时，记录了连续波多普勒二尖瓣反流情况。其中15名患者在不同的RR间期测量了6到8次心跳。通过应用修正的伯努利方程，以3毫秒的间隔，采用不同方法将多普勒速度曲线转换为左心室压力曲线。当使用零渐近线并了解左心室舒张末期压力时，导管法和多普勒法得出的TAU之间的相关性最佳。一种稍差但可接受的方法是在多普勒得出的心室 - 心房压力梯度上增加20 mmHg。使用非零渐近线计算TAU时，导管测量和多普勒测量之间的相关性较差。多普勒得出的TAU百分比变化与导管得出的TAU百分比变化之间的相关性较差。
结论。多普勒得出的二尖瓣反流速度信号的下降支可作为心室松弛速率的半定量估计。这种方法需要了解左心房压力，并且可能不够精确，无法逐次检测松弛速率的微小变化。
Background. The instantaneous pressure gradient between the left ventricle and left atrium during systole can be calculated from the mitral regurgitation Doppler velocity curve. The purpose of our study was to determine the accuracy of measuring the time constant of relaxation (TAU) derived from the Doppler mitral regurgitation signal by comparing it with simultaneous high-fidelity left ventricular pressure measurements in humans.Methods and Results. Twenty-five patients had continuous-wave Doppler mitral regurgitation recordings performed with simultaneous high-fidelity left ventricular pressure measurements. Fifteen of these patients had measurements of six to eight beats at various RR intervals. Doppler velocity curves were converted to left ventricular pressure curves by different methods through application of the modified Bernoulli equation at 3-msec intervals. The correlation between catheter-derived and Doppler-derived TAU was best when a zero asymptote and knowledge of the left ventricular end-diastolic pressure were used. A less optimal but acceptable method used the addition of 20 mm Hg to the Doppler-derived ventriculoatrial gradient. Use of a nonzero asymptote for calculation of TAU yielded poor correlation between catheter and Doppler measurements. The correlation of percentage change in Doppler-derived TAU plotted against percentage change in catheter-derived TAU was poor.Conclusions. The descending limb of the Doppler-derived mitral regurgitation velocity signal can be used as a semiquantitative estimate of the rate of ventricular relaxation. This method requires knowledge of left atrial pressure and may not be sufficiently accurate for detecting small changes in the rate of relaxation on a beat-to-beat basis.