COMPARISON OF ECHOCARDIOGRAPHIC METHODS FOR ASSESSMENT OF LEFT-VENTRICULAR SHORTENING AND WALL STRESS
COMPARISON OF ECHOCARDIOGRAPHIC METHODS FOR ASSESSMENT OF LEFT-VENTRICULAR SHORTENING AND WALL STRESS
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DOI：
10.1016/s0735-1097(87)80253-x
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发表时间：
1987-04-01
影响因子：
24
通讯作者：
SUTTON, MGS
中科院分区：
文献类型：
--
作者：
DOUGLAS, PS;REICHEK, N;SUTTON, MGS
m型超声心动图测量左心室短度和经壁应力已广泛用于单独或联合描述左心室收缩功能。为了确定二维超声心动图提供的改进的尺寸信息是否可能导致缩短和应力计算产生不同的左心室功能视图，我们比较了69例受试者的二维和m型超声心动图（19例正常，13例主动脉狭窄，22例主动脉反流和15例充血性心肌病）。所有受试者，尤其是心肌病患者，m型超声心动图的缩短分数大于二维超声心动图（p < 0.05）。主动脉瓣狭窄，二维缩短，24±。5%，与正常相比（p < 0.05），但m型缩短，为34。5%则不是。经络应力的m模式估计值高于二维值，特别是在心肌病中。二维超声心动图可以测定长、短轴比、周向应力和周向应力与子午应力的比值。主动脉瓣狭窄的周向应力在302±±时升高。65同学们。103达因/平方厘米，表明后载荷过量是二维缩短减少的原因。越球形的心肌病心脏，其子午应力比与周向应力比接近于1，因此单独使用子午应力会高估有效后负荷。结论：m型超声心动图和二维超声心动图分析左心室缩短和应力的结果不同。二维超声心动图方法可以提高心室功能的评估，特别是对主动脉狭窄和心肌病患者。
M-mode echocardiographic measurement of left ventricular fractional shortening and meridional wall stress has been used extensively alone and in combination to describe left ventricular systolic function. To determine whether the improved dimensional information afforded by two-dimensional echocardiography might result in shortening and stress calculations yielding a different view of left ventricular function, we compared two-dimensional and M-mode echocardiograms in 69 subjects (19 normal, 13 with aortic stenosis, 22 with aortic regurgitation and 15 with congestive cardiomyopathy). Fractional shortening was greater with M-mode than with two-dimensional echocardiography in all subjects, especially in those with cardiomyopathy (p < 0.05). In aortic stenosis, two-dimensional shortening, at 24 .+-. 5%, was reduced (p < 0.05 versus normal), but M-mode shortening, at 34 .+-. 5%, was not. M-mode estimates of meridional stress were higher than two-dimensional values, again especially in cardiomyopathy. Two-dimensional echocardiography enabled determination of long- and short-axis ratios, circumferential stress and the ratio of circumferential to meridional stresses. Circumferential stress was elevated in aortic stenosis at 302 .+-. 65 .times. 103 dynes/cm2, suggesting afterload excess as the cause for the observed reduction in two-dimensional shortening. The more spherical cardiomyopathic hearts had a meridional to circumferential stress ratio closer to 1, such that use of meridional stress alone would overestimate effective afterload. It is concluded that M-mode and two-dimensional echocardiographic analyses of left ventricular shortening and stress produce different results. Two-dimensional echocardiographic methods may enhance the assessment of ventricular function, especially in patients with aortic stenosis and cardiomyopathy.