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首页> 外文期刊>Korean Circulation Journal >Diastolic Dysfunction of Left Ventricle during Transient Myocardial Ischemia : Usefulness of Color M-mode Doppler Echocardiography
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Diastolic Dysfunction of Left Ventricle during Transient Myocardial Ischemia : Usefulness of Color M-mode Doppler Echocardiography

机译：短暂性心肌缺血期间左心室舒张功能障碍：彩色M型多普勒超声心动图的有用性

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Background Left ventricular diastolic dysfunction may precede systolic dysfunction and play a major role in producing the signs and symptoms of congestive heart failure. Ischemic heart disease can cause impairment of left ventricular filling without any alteration in systolic function so it is very important to evaluate relationship of left ventricular diastolic dysfunction and ischemic heart disease. The purpose of this study is to investigate left ventricular diastolic dysfunction during transient myocardial ischemia caused by balloon occlusion. Methods We prospectively studied 20 patients(11 males and 9 females, mean age : 58.5±5.9 years) who had been undergone coronary angiography and confirmed significant luminal stenosis(≥75%)in proximal or middle portion of left anterior descending artery. After coronary angiography, percutaneous transluminal coronary angioplasty were performed all patients. We measured early propagation slope of left ventricular inflow, time difference(TD) between occurrence of peak velocity in the apical region and at the mitral tip and normalized TD(nTD) which dividing TD by the distance of mitral opening to apical region using color M-mode Doppler echocardiography, peak earaly diastolic transmitral inflow velocity(E), peak velocity during atrial contraction(A), E to A ratio, acceleration time of E wave and deceleration time of E wave using pulsed wave Doppler echocardiography, left ventricular end diastolic pressure using left heart catheterization. A color M-mode Doppler echocardiography, pulsed wave Doppler echocardiography and left ventricular end diastolic pressure were recorded before, during 30sec, 60sec & 90sec and after 60sec & 180sec balloonocclusion. Results Early propagation slope of left ventricular inflow was significantly decreased during 30sec & 60sec balloon occlusion and significantly increased after 60sec & 180sec balloon occlusion, respectively(64.45±28.23cm/sec, 39.37±11.77cm/sec, 32.78±11.77cm/sec, 51.86±19.78cm/sec, 65.05±29.99cm/sec, p Conclusion These data suggest that transient myocardial ischemia can cause left ventricular diastolic dysfunction and color M-mode Doppler echocardiography is very sensitive diagnostic method to detect early diastolic dysfunction compare to other echocardiographic diastolic indices.
机译：背景技术左心室舒张功能障碍可能先于收缩功能障碍，并在产生充血性心力衰竭的体征和症状中起主要作用。缺血性心脏病可以导致左心室充盈受损，而收缩功能没有任何改变，因此评估左心室舒张功能障碍与缺血性心脏病之间的关系非常重要。这项研究的目的是调查球囊闭塞引起的短暂性心肌缺血期间左心室舒张功能障碍。方法我们前瞻性研究了20例患者，其中男11例，女9例，平均年龄：58.5±5.9岁，他们接受了冠状动脉造影，并确认左前降支近端或中段有明显的腔狭窄（≥75％）。冠状动脉造影后，对所有患者进行经皮腔内冠状动脉成形术。我们使用颜色M测量了左心室流入的早期传播斜率，在心尖区域和二尖瓣尖端出现峰值速度之间的时间差（TD）和归一化的TD（nTD）（将TD除以二尖瓣开口到心尖区域的距离）式多普勒超声心动图，舒张峰值峰值流入速度（E），心房收缩期间的峰值速度（A），E与A之比，脉冲波多普勒超声心动图的E波加速时间和E波减速时间，左心室舒张末期使用左心导管置压。在30秒，60秒和90秒，60秒和180秒后，分别记录彩色M型多普勒超声心动图，脉冲多普勒超声心动图和左心室舒张末期压力。结果在30秒和60秒球囊闭塞时左心室流入的早期传播斜率显着降低，而在60秒和180秒球囊闭塞后左室流入的早期传播斜率分别显着增加（64.45±28.23cm / sec，39.37±11.77cm / sec，32.78±11.77cm / sec，结论51.86±19.78cm / sec，65.05±29.99cm / sec，p结论这些数据表明短暂性心肌缺血可引起左心室舒张功能障碍，彩色M型多普勒超声心动图是检测早期舒张功能障碍的非常灵敏的诊断方法，与其他超声心动图相比舒张指数。

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