Limitations of two frame method for displaying regional left ventricular wall motion in man.
Limitations of two frame method for displaying regional left ventricular wall motion in man.
复制标题
显示人体局部左心室壁运动的两帧方法的局限性。
DOI：
10.1136/hrt.44.5.555
复制
发表时间：
1980
影响因子：
--
通讯作者：
D. Gibson
中科院分区：
文献类型：
--
作者：
D. Marier;D. Gibson
左心室功能的区域异常经常通过舒张末期和收缩末期的叠加空腔轮廓来确定。舒张末期的时间是根据心电图标准化的，但收缩末期的时间是不确定的，并且经常通过简单的检查来确定。为了检查收缩末期帧时序变化对明显局部室壁运动的影响，将来自缺血性心脏病患者的 35 幅左心室血管造影照片逐帧数字化，并将主动脉瓣关闭和二尖瓣开放的时序叠加在轮廓显示上。在15名患者中，以收缩末期作为主动脉瓣关闭时的两帧显示中的模式与作为二尖瓣开放时的模式相似。然而，在剩下的 20 个中，由于等容舒张过程中空腔形状的变化，两者之间存在重大差异。这些形状变化是心室不同区域收缩期异步终止的结果。此外，等容舒张期间左心室腔面积显着增加了 3.9 +/- 1.7%，对应于计算体积增加了 8.1 +/- 4.5%。因此，从射血末期获得的收缩末期得出的射血分数估计值始终大于二尖瓣开放时的射血分数估计值。与介入血管造影或手术后报告的结果相比，由于缺乏收缩末期定义而导致的局部室壁运动明显模式的差异很大。因此，如果要使用两帧方法，则必须标准化收缩末期的时间。我们建议使用末端弹出。等容舒张过程中形状的变化应单独考虑。
Regional abnormalities of left ventricular function are frequently determined from superimposed cavity outlines at end-diastole and end-systole. The timing of end-diastole is standardised with respect to the electrocardiogram, but that of end-systole is undefined, and frequently determined by simple inspection. To examine the effect of variation in the timing of the end-systolic frame on apparent regional wall motion, 35 left ventricular angiograms from patients wit ischaemic heart disease were digitised frame by frame, and the timing of aortic valve closure and mitral valve opening superimposed on contour displays. In 15 patients, the pattern in the two frame display with end-systole taken as aortic valve closure was similar to that when it was taken as mitral valve opening. In the remaining 20, however, there were major discrepancies between the two, because of changes in cavity shape during isovolumic relaxation. These shape changes were the result of asynchronous termination of systole in different regions of the ventricle. In addition, there was a significant increase in left ventricular cavity area of 3.9 +/- 1.7 per cent during isovolumic relaxation, corresponding to an increase in calculated volume of 8.1 +/- 4.5 per cent. Estimates of ejection fraction derived from end-systole taken at end-ejection were thus consistently greater than those at mitral valve opening. These differences in the apparent pattern of regional wall motion resulting from lack of definition of end-systole are large compared with those reported after intervention angiography, or surgery. Thus, if two frame methods are to be used, the timing of end-systole must be standardised. We suggest that end-ejection be used. Changes of shape during isovolumic relaxation should be considered separately.