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首页> 外文期刊>American Journal of Physiology >Contribution of mitral annular excursion and shape dynamics to total left ventricular volume change.
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Contribution of mitral annular excursion and shape dynamics to total left ventricular volume change.

机译：二尖瓣环偏移和形状动力学对总的左心室容积变化的贡献。

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The mitral annulus (MA) has a complex shape and motion, and its excursion has been correlated to left ventricular (LV) function. During the cardiac cycle the annulus' excursion encompasses a volume that is part of the total LV volume change during both filling and emptying. Our objective was to evaluate the contribution of MA excursion and shape variation to total LV volume change. Nine healthy subjects aged 56 +/- 11 (means +/- SD) years underwent transesophageal echocardiography (TEE). The MA was outlined in all time frames, and a four-dimensional (4-D) Fourier series was fitted to the MA coordinates (3-D+time) and divided into segments. The annular excursion volume (AEV) was calculated based on the temporally integrated product of the segments' area and their incremental excursion. The 3-D LV volumes were calculated by tracing the endocardial border in six coaxial planes. The AEV (10 +/- 2 ml) represented 19 +/- 3% of the total LV stroke volume (52 +/- 12 ml). The AEV correlated strongly with LV stroke volume (r = 0.73; P < 0.05). Peak MA area occurred during middiastole, and 91 +/- 7% of reduction in area from peak to minimum occurred before the onset of LV systole. The excursion of the MA accounts for an important portion of the total LV filling and emptying in humans. These data suggest an atriogenic influence on MA physiology and also a sphincter-like action of the MA that may facilitate ventricular filling and aid competent valve closure. This 4-D TEE method is the first to allow noninvasive measurement of AEV and may be used to investigate the impact of physiological and pathological conditions on this important aspect of LV performance.
机译：二尖瓣环（MA）具有复杂的形状和运动，其偏移与左心室（LV）功能相关。在心动周期中，环的偏移量是充盈和排空期间总LV体积变化的一部分。我们的目标是评估MA偏移和形状变化对总LV体积变化的贡献。 9名年龄在56 +/- 11岁（平均+/- SD）的健康受试者接受了经食道超声心动图检查（TEE）。在所有时间范围内概述了MA，并且将四维（4-D）傅里叶级数拟合到了MA坐标（3-D +时间）并将其划分为多个部分。环形偏移量（AEV）是根据分段面积与其增量偏移量的时间积分积计算得出的。通过在六个同轴平面内追踪心内膜边界来计算3-D LV体积。 AEV（10 +/- 2 ml）代表总左心室搏动量（52 +/- 12 ml）的19 +/- 3％。 AEV与左室卒中量密切相关（r = 0.73; P <0.05）。 MA峰面积出现在舒张中期，LV收缩期开始前，峰面积减少91 +/- 7％。 MA的漂移占人体总LV充盈和排空的重要部分。这些数据表明对MA生理有心源性影响，也可能对MA括约肌有类似括约肌的作用，这可能有助于心室充盈并有助于关闭瓣膜。这种4-D TEE方法是第一种允许无创测量AEV的方法，可用于研究生理和病理状况对LV性能这一重要方面的影响。

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