双脉冲波多普勒超声成像同步评价健康成年人左心室心肌与心包运动
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2013 6 10 6ChinJMedUltrasound(ElectronicEdition),June2013,Vol.10,No.6 R443双 脉 冲 波 多 普 勒 超 声 成 像 同 步 评 价 健 康成 年 人 左 心 室 心 肌 与 心 包 运 动DOI:10.3877/cma.j.issn.1672-6448.2013.06.004:(30970698):610072, :,Email:yinlixue@yahoo.com,。 99 3、、,、 6。。 3、、、、,。,,致,。:、,;、,、,,(t -4.207、-2.078、4.575、-2.277、-2.440、-2.292、5.980、2.604,P <0.05)。:、,(t -2.447、-2.020,P <0.05)。:,(t -3.530、-2.411,P <0.05)。、、(r 0.4070.933,P <0.01)。、致。。,,;,,;;Synchronous motion assessment of left vent ricular myocardium and per icardium in normal adultusing dual pulse wave Doppler echocardiographyCHENG Chong-qing,YIN Li-xue,SHEN Yu-ping,ZHANGLi-juan.Institute of Ultrasound in Medicine,Key Laboratory of Ultrasound in Cardiac Electrophysiologyand Biomechanics of Sichuan,Sichuan Academy of Medica l Sciences &Sichuan Provincial People′s Hospital,Chengdu 610072,ChinaCorresponding author:YIN Li-xue,Email:yinlixue@yahoo.comAbstractObjectiveToinvestigatetheclinicalvalue,themotiveregularity,thetemporalandspatialcorelationbetweenmyocardium andadjacentpericardium ofleftventricularshort-axisinnormaladsultsbyusingdualpulsewaveDopplerechocardiography.MethodsTisuedualpulsespectralDopplerimagesaboutsegmentalmyocardiumandadjacentpericardialofthre completecardiaccyclesin 99normaladultswerecolectedsynchronouslybyusingdualpulsewaveDopplertechenology,6segmentswereenroledinthisstudy,includingtheanteriorandposteriorwalatmitralvalve,papilarymuscles,andapexlevelofleftventricularshort-axisview.Themotiveregularityofmyocardiumandadjacentpericardiumatdiferentlevelsandsegmentswereobserved.Peaksped,onsettimeandpeaktimebetweenmyocardiumandadjacentpericardiuminanteriorandposteriorwalofthre valvesweremeasuredonlineinsystolic,earlydiastolic,andlatediastolic,andthecorelationbetweensegmentalmyocardiumandadjacentpericardiuminspedand R444 2013 6 10 6ChinJMedUltrasound(ElectronicEdition),June2013,Vol.10,No.6timewereanalyzed.ResultsDualpulsewaveDopplerechocardiographyshowedthatinleftventricularshort-axisview,motionbetweenmyocardiumandadjacentpericardiuminthesamesegmenthadconsistentdirection,motionsbetweenmyocardiumandadjacentpericardiuminanteriorandposteriorwalatthesamelevelhadoppositedirections.Comparisonofpeakvelocity,inanteriorwal,thepeakvelocitiesofmyocardiuminsystolicandlatediastolicatmitralvalvelevel,andthepeakvelocityofmyocardium insystolicatpapilarymusclelevelwerelowerthanthatofadjacentpericardium.Inposteriorwal,thepeakvelocitiesofmyocardium inearlydiastolicandlatediastolicatmitralvalvelevel,thepeakvelocitiesofmyocardiuminsystolicandearlydiastolicatpapilarymusclelevel,andthepeakvelocityofmyocardiuminearlydiastolicatapexlevelwerehigherthanthatofadjacentpericardium,withstatisticalsignificance(t-4.207,-2.078,4.575,-2.277,-2.440,-2.292,5.980,2.604,alP <0.05).Comparisonofonsettime,theonsettimeofmyocardiuminsystolicatpapilarymusclelevelinanteriorwal,andtheonsettimeofmyocardiuminearlydiastolicatmitralvalvelevelinposteriorwalwerelowerthanthatofadjacentpericardium,withstatisticalsignificance(t -2.447,-2.020,bothP <0.05).Comparisonofpeaktime,exceptthepeaktimeofmyocardiuminsystolicandearlydiastolicatmitralvalvelevelinposteriorwalwaslowerthanthatofadjacentpericardium,theremainingdiferenceswerestatisticalysignificant(t-3.530,-2.411,bothP <0.05).Peakvelocity,onsettimesandpeaktimesofeachsegmentmeasuredbetweenmyocardiumandadjacentpericardium werewelcorelated(r 0.407-0.933,alP <0.01).ConclusionsDualpulsewaveDopplerechocardiographycanproviderelativityandacordancebetweenmotivevelocityanddirectionofleftventricularmyocardiumandadjacentpericardiuminnormaladults.Itisapromisingnewmethodfortheclinicaldiagnosisofconstrictivepericarditisanddiferentiationwithrestrictivecardiomyopathy.Key wordsEchocardiography,Doppler,pulsed;Ultrasonography,Doppler,duplex;Myocardium;Pericardium [1],致,。,[2]。(dualpulsewaveDopplerechocardiography),,致、。,,。、20125至6 99, 49, 50,2049,(36.1011.91),、。、 HIVisionAscendus,, 24MHz。,,。,dual”, >100/s,23mm,,。、、 3。 3 6,、、、。 3,。,,,(V), VV /[3]。(T),[4], TT [1( -70)/70](70,:ms)。、 SPSS17.0,2013 6 10 6ChinJMedUltrasound(ElectronicEdition),June2013,Vol.10,No.6 R445, 珋x s 。、、、、 t 。、。 P <0.05。1.:,,致,。,;,、。,;,、(1,2)。2.:,,、,。、、,、,、,,。(1)。3.:、,、、。( 2)。4.:、,、、。( 3)。 1(cm/s,珋x s) Vs Ve Va Vs Ve Va 99 m3 Ζ.390.91a 3 H.981.28 3 .190.90a 5 h.861.45 9 骀.242.62a 4.331.30a 99 m3 Ζ.720.90 4 H.091.32 3 .371.00 5 h.621.44 8 骀.132.34 4.031.35r 0 Ζ.665 0 H.762 0 .615 0 h.407 0 骀.535 0.571P 0 Ζ.000 0 H.000 0 .000 0 h.000 0 骀.000 0.000 Vs Ve Va Vs Ve Va 99 m3 Ζ.450.93a 4 H.061.29 3 .160.91 5 V.641.49a 10.343.22a 3.991.47 99 m3 Ζ.661.04 4 H.111.51 3 .301.03 5 V.351.60 8.602.41 3.851.44r 0 Ζ.669 0 H.731 0 .701 0 V.626 0.513 0.706P 0 Ζ.000 0 H.000 0 .000 0 V.000 0.000 0.000 Vs Ve Va Vs Ve Va 99 m3 .510.99 4 H.241.40 3.121.11 5 h.621.71 8 骀.882.45a 4.071.40 99 m3 .651.08 4 H.211.56 3.221.11 5 h.591.72 8 骀.312.34 3.951.46r 0 .677 0 H.728 0.784 0 h.799 0 骀.617 0.727P 0 .000 0 H.000 0.000 0 h.000 0 骀.000 0.000:a , (t -4.207、-2.078、4.575、-2.277、-2.440、-2.292、5.980、2.604,P <0.05)。Vs;Ve;Va R446 2013 6 10 6ChinJMedUltrasound(ElectronicEdition),June2013,Vol.10,No.6 2(ms,珋x s) Ts Te Ta Ts Te Ta 99 m132 .1926.32 513 .0060.46 742.1643.82 62 h.2914.68 397.6539.13a 734.3351.78 99 m131 .5823.70 513 .8559.57 746.1441.65 61 h.1313.67 403.5840.83 731.7751.60r 0 .773 0 .876 0.717 0 h.453 0.820 0.768P 0 .000 0 .000 0.000 0 h.000 0.000 0.000 Ts Te Ta Ts Te Ta 99 m127 .6118.57a 502 .6140.62 746.6533.86 63 h.2420.35 394.0853.61 743.0290.77 99 m130 .2220.35 500 .8749.48 751.6232.93 63 h.9619.36 397.8955.00 743.6473.38r 0 .800 0 .730 0.755 0 h.749 0.834 0.717P 0 .000 0 .000 0.000 0 h.000 0.000 0.000 Ts Te Ta Ts Te Ta 99 m129 .8722.08 499 .3244.73 762.3939.06 56 h.3715.87 399.3751.37 740.2042.63 99 m131 .6920.62 502 .9139.99 764.5838.71 57 h.3216.18 401.8454.46 744.6446.15r 0.776 0.781 0 .890 0 .574 0 ].817 0 ..696P 0.000 0.000 0 .000 0 .000 0 ].000 0 ..000:a,(t -2.447、-2.020,P <0.05)。 Ts ;Te;Ta 3(ms,珋x s) Ts Te Ta Ts Te Ta 99 m171 .7425.32 550 .7059.48 783.0441.91 115 j.7419.04a 461.2842.50 783.8253.30a 99 m170 .6223.00 555 .2458.78 787.0639.51 110 j.0016.03 463.1845.82 788.4353.08r 0 .797 0 .851 0.751 0 j.661 0.930 0.828P 0 .000 0 .000 0.000 0 j.000 0.000 0.000 Ts Te Ta Ts Te Ta 99 m168 .7620.18 540 .8042.13 788.5232.37 115 .8332.10 465.0663.30 792.9494.35 99 m169 .3323.34 542 .0149.60 792.1229.41 110 .7024.58 465.4358.83 794.2576.32r 0.787 0.659 0 .742 0 .765 0 ].933 0 ..761P 0.000 0.000 0 .000 0 .000 0 ].000 0 ..000 Ts Te Ta Ts Te Ta 99 m174 .0525.22 545 .6145.06 801.4836.26 105 .0022.33 477.5653.69 790.7741.80 99 m172 .8123.46 548 .9440.69 803.0638.14 103 .7620.05 476.2152.43 793.8143.50r 0.824 0.822 0 .783 0 .698 0 ].855 0 ..730P 0.000 0.000 0 .000 0 .000 0 ].000 0 ..000:a,(t -3.530、-2.411,P <0.05)。 Ts ;Te;Ta2013 6 10 6ChinJMedUltrasound(ElectronicEdition),June2013,Vol.10,No.6 R447 1,2。 1,,,,、; 2,,,、,、M、[5-7],,。、、,。, 。,致。。,致。(2050ml),[8]。[9]。, Lu[10]致。,,。:,,,,,。,,,。、,,。,。,,[11],[12],[10],致,,[13]。,,[14],,,、,,。,。,,。, R448 2013 6 10 6ChinJMedUltrasound(ElectronicEdition),June2013,Vol.10,No.6,23mm。,。,,,。,, VV /[3]。,[4]。:,dual”。,。,,。,,,。 1,,. . ,2010,12(26):890-893.2DohiK,PinskyMR,KanzakiH,etal.Efectsofradialleftventriculardyssynchrony on cardiac performance using quantitative tissueDopplerradialstrainimaging.JAmSocEchocardiogr,2006,19(5):475-482.3,,. .,2009,6(14):453-454.4,,. [J/CD]. : ,2012,3(9):268-273.5ZwasDR,Admon D,KerenA.Advancesin thediferentiationofconstrictivepericarditisandrestrictivecardiomyopathy.Herz,2012,37(6):664-674.6MarkusS,ReneA,JanH,etal.Constrictivepericarditis,stiladiagnosticchalenge:comprehensivereviewofclinicalmanagement.EurJCardioThoracicSur,2009,36(3):502-510.7NihoyannopoulosP,DawsonD.Restrictivecardiomyopathies.EurJEchocardiogr,2009,10(8):ii23-33.8,,. [J/CD]. ,2011,13(5):3732-3736.9HadaY,ItchN,TohyoY,etal.IntramyocardialpulsedDopplerechocardiograasanewmodalityforevaluationofventriecularwalmotion,assesmentinnormalsubjects.JCardiol,1996,28(2):85-92.10LuXF,WangXF,ChengTO.DiagnosisofconstrictivepericarditisbyquantitativetissueDopplerimaging.IntJCardiol,2009,137(1):22-28.11,. .2. :,2008.12HancockE.Diferentialdiagnosisofrestrictivecardiomyopathyandconstrictivepericarditis.Heart,2001,86(3):343-349.13OkiT,TabataT,YamadaH.Rightandleftventricularwallmotionvelocitiesasdiagnosticindicatorsofconstrictivepericarditis.Am JCardiol,1998,81(4):465-470.14,. .,2009,10(28):1483-1485.(:2013-01-16)(:),,,.[J/CD].:,2013,10(6):443-448.
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