Usefulness of pulsed tissue Doppler imaging for evaluating systolic and diastolic left ventricular function in patients with AL (Primary) amyloidosis
Usefulness of pulsed tissue Doppler imaging for evaluating systolic and diastolic left ventricular function in patients with AL (Primary) amyloidosis
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DOI：
10.1016/s0002-9149(02)02277-4
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发表时间：
2002-05-01
影响因子：
2.8
通讯作者：
Falk, RH
中科院分区：
文献类型：
--
作者：
Koyama, J;Ray-Sequin, PA;Falk, RH
为了阐明多个左心室IV部位的脉冲组织多普勒成像是否有助于解释原发性淀粉样变性患者充血性心力衰竭（CHF）的机制，我们检查了86例经活检证实的原发性淀粉样变性患者（I组，31例无心脏受累，II组，31例有心脏受累但无CHF; III组24例，心脏受累，临床CHF，正常短轴缩短率>28%。舒张早期峰值速度Ⅱ组明显低于Ⅰ组，Ⅲ组多数部位也明显低于Ⅱ组。与舒张期异常相反，III组收缩期室壁运动速度峰值显著低于II组，但I组和II组之间无显著差异。因此，心脏淀粉样变性的特征在于早期心脏舒张的初始损害，而CHF与收缩期峰值室壁运动速度的损害相关，最显著地见于纵轴。即使射血分数在正常范围内，这种收缩功能障碍也可以通过脉冲组织多普勒成像检测到。(C)2002年，Excerpta Medica，Inc.
To clarify whether pulsed tissue Doppler imaging at multiple left ventricular IV sites could help to explain the mechanism of congestive heart failure (CHF) in patients with primary amyloidosis, we examined 86 consecutive patients with primary amyloidosis confirmed by biopsy (group I, 31 patients without cardiac involvement; group II, 31 patients with evidence of heart involvement but no CHF; and group III, 24 patients with heart involvement, clinical CHF, and normal fractional shortening >28%). Peak early diastolic myocardial velocities in group II were significantly lower than those in group I, an the values in group III were also significantly lower than those in group II at most sites. In contrast to diastolic abnormalities, peak systolic wall motion velocities in group III were significantly lower than those in group II, but there were no significant differences between groups I and II. Thus, cardiac amyloidosis is characterized by an initial impairment in early cardiac relaxation, whereas CHF is associated with an impairment of peak systolic wall motion velocities, most prominently seen in the longitudinal axis. This systolic dysfunction can be detected by pulsed tissue Doppler imaging, even when ejection fraction is in the normal range. (C) 2002 by Excerpta Medica, Inc.