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Visualization of coronary blood flow using Doppler echocardiography and its clinical applications.

使用多普勒超声心动图显示冠状动脉血流及其临床应用。

基本信息

批准号：
62480222
负责人：
BEPPU Shintaro
金额：
$ 4.16万
依托单位：
National Cardiovascular Center Research Institute
依托单位国家：
日本
项目类别：
Grant-in-Aid for General Scientific Research (B)
财政年份：
1987
资助国家：
日本
起止时间：
1987 至 1989
项目状态：
已结题

项目摘要

We attempted to assess the blood flow of the coronary artery noninvasively using pulsed Doppler echocardiography. At the first year of this project, 3.6 MHz Doppler equipment was used for transthoratic approach. As for left anterior descending artery, Doppler signal was detected inside of the thin vessel with 1 to 2 mm width. The flow signal was characteristic showing rapid and steady flow throughout diastole followed by the 2nd heart sound. The peak velocity was 44-71 mm/sec in hypertrophic cardiomyopathy, which was significantly faster than 25-43 cm/sec in dilated cardiomyopathy. The flow velocity was also influenced by drugs, such as reduction by nitroglycerin. Although the transthoratic approach provides the useful information, the sensitivity for detecting coronary flow was low. At the 2nd year, transesophageal echocardiography was used. The transducer is set at the tip of the gastrofiberscope with 9 mm width. The echo of the left main trunk was detected about 80% of the patients and the Doppler signal of the coronary blood flow was observed in all of these 80% patients. The maximum velocity of the diastolic flow detected by this method was 40+/-14 cm/sec. Intraaortic balloon pumping augmented the diastolic flow velocity of the coronary artery, indicating not only its assisting effect of systemic circulation but also benefiting effect to the coronary circulation. In the last year, Coronary flow was assessed by Doppler catheter, in which the 20 MHz microtransducer was attached to its tip. Methodology for calculating flow velocity of blood was evaluated, and it was shown that FFT method was superior to the zero- cross method. Maximum flow velocity was reduced in a narrowed coronary artery.We have assessed the coronary flow in various disease or interventions using Doppler echocardiography and revealed its usefulness in the clinical setting.

我们尝试用脉冲多普勒超声心动图无创地评估冠状动脉的血流。在该项目的第一年，3.6 MHz多普勒设备用于经胸入路。左前降支在1 ~ 2 mm宽的细血管内可见多普勒信号。血流信号是特征性的，显示在第二心音之后整个二尖瓣中快速和稳定的血流。肥厚型心肌病的峰值速度为44-71 mm/sec，明显快于扩张型心肌病的25-43 cm/sec。硝酸甘油还原等药物对血流速度也有影响。虽然经胸入路提供了有用的信息，但检测冠状动脉血流的敏感性较低。在第2年，使用经食管超声心动图。传感器设置在纤维胃镜的尖端，宽度为9 mm。约80%的患者可检测到左主干回声，所有这80%的患者均可观察到冠状动脉血流的多普勒信号。通过该方法检测的舒张期血流的最大速度为40+/-14 cm/sec。主动脉内球囊反搏可增加冠状动脉舒张期血流速度，不仅对体循环有辅助作用，而且对冠状动脉循环也有有益作用。在过去的一年里，冠状动脉血流是通过多普勒导管，其中20 MHz的微传感器连接到其尖端。对计算血液流速的方法进行了评价，结果表明FFT法优于过零法，具有上级优点。冠状动脉狭窄时最大血流速度降低，我们使用多普勒超声心动图评估了各种疾病或介入治疗时的冠状动脉血流，并揭示了其在临床环境中的实用性。