Assessment of left ventricular function using mitral annular velocities in patients with congestive heart failure with or without the presence of significant mitral regurgitation
Assessment of left ventricular function using mitral annular velocities in patients with congestive heart failure with or without the presence of significant mitral regurgitation
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DOI：
10.1067/mje.2003.52
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发表时间：
2003-03-01
影响因子：
6.5
通讯作者：
Samad, B
中科院分区：
文献类型：
--
作者：
Alam, M;Wardell, J;Samad, B
应用脉冲多普勒组织成像技术研究充血性心力衰竭（CHF）患者的心肌运动速度。在二尖瓣和三尖瓣环处记录速度。选择二尖瓣环处的四个部位，对应于心尖四腔和二腔视图的左心室间隔壁、侧壁、下壁和前壁。选择上述4个部位的平均值来描述二尖瓣环运动速度。仅选择三尖瓣环的一个部位，对应于右心室游离壁。记录三种不同的瓣环速度：收缩期峰值、舒张早期峰值和舒张晚期峰值。共有96名患者与12名年龄匹配的健康参与者进行了比较。与健康受试者相比，CHF患者的二尖瓣和三尖瓣收缩期流速显著降低（二尖瓣环为4.9 vs 9.3 cm/s，P <0.001，三尖瓣环为10.4 vs 14.6 cm/s，P <0.001）。与健康受试者相比，患者的舒张早期流速也降低（二尖瓣环5-9 vs 10.9 cm/s，P <0.001，三尖瓣环8.6 vs 12.9 cm/s，P <0.001）。CHF患者左心室射血分数（EF）严重降低（27%）。二尖瓣环收缩期血流速度与EF值相关性较好（r = 0.59，P <0.001）. CHF患者根据是否存在显著二尖瓣返流分为2个亚组。在有明显二尖瓣反流（r = 0.61，P <0.001）和无明显二尖瓣反流（r = 0.59，P <0.001）的患者中，EF与收缩期二尖瓣环速度均存在相关性。总之，与健康受试者相比，CHF患者的二尖瓣和三尖瓣环速度显著降低。EF和收缩期二尖瓣环速度之间的相关性相对较好，无论是否存在显著的二尖瓣返流。测量环速度是评估CHF患者的一种简单而有用的方法。
Myocardial velocities in patients with congestive heart failure (CHF) were studied using pulsed wave Doppler tissue imaging. Velocities were recorded at the mitral and tricuspid annulus. Four sites at the mitral annuli were selected corresponding to the septal, lateral, inferior, and anterior walls of the left ventricle from apical 4- and 2-chamber views. A mean value from the above 4 sites was selected to describe the mitral annular velocities. only one site of the tricuspid annulus was selected, corresponding to the right ventricular free wall. Three different annular velocities were recorded: the peak systolic, and the peak early and late diastolic velocities. A total of 96 patients were compared with 12 age-matched healthy participants. Patients with CHF had significantly decreased mitral and tricuspid systolic velocities compared with healthy participants (4.9 vs 9.3 cm/s, P < .001, for the mitral annulus and 10.4 vs 14.6 cm/s, P < .001, for the tricuspid annulus). The early diastolic velocity was also reduced in patients compared with healthy participants (5-9 vs 10.9 cm/s, P < .001, for the mitral annulus and 8.6 vs 12.9 cm/s, P < .001, for the tricuspid annulus). Patients with CHF had a severely depressed left ventricular ejection fraction (EF) (27%). The correlation the between systolic mitral annular velocity and EF was relatively good (r = 0.59 and P < .001). The patients with CHF were divided into 2 subgroups depending on the presence or absence of significant mitral regurgitation. There was a correlation between EF and the systolic mitral annular velocity both in patients with (r = 0.61, P < .001) and without (r = 0.59, P < .001) significant mitral regurgitation. In conclusion, compared with healthy participants, the mitral and tricuspid annular velocities are significantly decreased in patients with CHF. The correlation between EF and the systolic mitral annular velocity is relatively good irrespective of the presence or absence of significant mitral regurgitation. Measurements of annular velocities constitute a simple and useful method for evaluating patients with CHF.