Hemodynamic determinants of the mitral annulus diastolic velocities by tissue Doppler
Hemodynamic determinants of the mitral annulus diastolic velocities by tissue Doppler
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DOI：
10.1016/s0735-1097(00)01056-1
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发表时间：
2001-01-01
影响因子：
24
通讯作者：
Khoury, DS
中科院分区：
文献类型：
--
作者：
Nagueh, SF;Sun, HB;Khoury, DS
我们的目标是确定二尖瓣环（MA）舒张期速度的组织多普勒血流动力学决定因素。背景MA舒张期速度是左心室（LV）舒张功能的有前途的指标。然而，他们的血流动力学的决定因素尚未evaluated.METHODS 10只成年杂种犬进行了左心房（LA）和左心室压力测量米勒导管，而组织多普勒应用于记录MA舒张期速度在间隔和侧角。还获得了常规的二尖瓣血流。通过液体给药和腔静脉闭塞改变左心房和LV压力，而多巴酚丁胺和艾司洛尔用于改变LV和LA舒张。结果：在大多数犬中，舒张早期血流速度（Ea）与跨瓣压差呈显著正相关（r = 0.57，p = 0.04）; Ea与tau（r =-0.83，p < 0.001）、LV-dP/dt（r = 0.8，p < 0.001）和最小LV压（r =-0.76，p < 0.01）具有强相关性。而在tau >50 ms的实验阶段，Ea与跨瓣压差无相关性，MA两角舒张晚期流速与LA dP/dt呈显著正相关（r = 0.67，p < 0.01）和LA舒张（r = 0.73，p < 0.01），但与左室舒张末期压呈负相关结论：左室舒张功能、最小压力和前负荷决定Ea，舒张晚期速度决定因素包括LA dP/dt、LA舒张功能和LV舒张末期压。（J Am Coil Cardiol 2001;37：278-85）（C）美国心脏病学会2001年。
OBJECTIVES Our goal was to identify the hemodynamic determinants of the mitral annulus (MA) diastolic velocities by tissue Doppler.BACKGROUND The MA diastolic velocities are promising indexes of left ventricular (LV) diastolic function. However, their hemodynamic determinants have not yet been evaluated.METHODS Ten adult mongrel dogs underwent left atrial (LA) and LV pressure measurements by Millar catheters while tissue Doppler was applied to record the MA diastolic velocities at the septal and lateral corners. Conventional transmitral flow was also obtained. Left atrial and LV pressures were modified utilizing fluid administration and caval occlusion, whereas dobutamine and esmolol were used to change LV and LA relaxation. Left ventricular filling pressures were altered during different lusitropic states to evaluate for the possible interaction of preload and LV relaxation on the early diastolic velocity (Ea).RESULTS In the majority of dogs, a positive significant relation was observed between Ea and the transmitral pressure gradient (r = 0.57, p = 0.04). The Ea had strong correlations with tau (r = -0.83, p < 0.001), LV -dP/dt (r = 0.8, p < 0.001) and minimal LV pressure (r = -0.76, p < 0.01). However, there was no relation between Ea and the transmitral pressure gradient in experimental stages where tau >50 ms. Furthermore, the late diastolic velocity at both corners of the MA had significant positive relations with LA dP/dt (r = 0.67, p < 0.01) and LA relaxation (r = 0.73, p < 0.01) but an inverse correlation with LV end-diastolic pressure (r = -0.53, p = 0.01).CONCLUSIONS Left ventricular relaxation, minimal pressure and preload determine Ea while late diastolic velocity determinants include LA dP/dt, LA relaxation and LV end-diastolic pressure. (J Am Coil Cardiol 2001;37:278-85) (C) 2001 by the American College of Cardiology.