Age-related changes in diastolic atrioventricular annular velocity: Studies using pulsed Doppler tissue imaging

Age-related changes in the diastolic velocity of the mitral and tricuspid annuli were studied in 67 healthy subjects aged 15 to 79 years. Ventricular inflow velocities were recorded by pulsed Doppler echocardiography with sample volumes at the mitral and tricuspid orifices in the apical four-chamber view, and peak early (E) and late (A) diastolic velocities were measured. Atrioventricular annular velocities were recorded by Doppler tissue imaging with sample volume set on the lateral portion of each annulus in the same view, and peak early (Ea) and late (Aa) diastolic velocities were determined. E and Ea correlated inversely with age, while A and Aa correlated directly with age in both ventricles. E/A and Ea/Aa ratios correlated inversely with age in both ventricles. Coefficients of correlation of these variables with age were higher for annular velocity than for inflow velocity. The E/A ratio at the tricuspid orifice was higher than that at the mitral orifice in all decades. An E/A ratio of less than 1 was observed at the mitral orifice in the sixth decade, but at the tricuspid orifice in the seventh decade. The Ea/Aa ratio at the tricuspid annulus was lower than that at the mitral annulus in all decades. The Ea/Aa ratio was less than 1 at the mitral annulus in the fifth decade and at the tricuspid annulus in the fourth decade. Diastolic function of both ventricles thus deteriorates with age, and diastolic annular velocity reflects ventricular diastolic function more accurately than ventricular inflow velocity.     

健康人左室质量与舒张功能的关系

目的：探讨健康人左室质量与左室舒张功能的关系。方法：随机选取健康教师320名，行彩色多普勒超声心动图检查，结果：相关分析显示：伴随左室质量的增加E波的峰值速度下降，A波的峰值增加，二者比值下降，等容松驰时间延长，肺静脉收缩波峰值与舒峰值之比增加，但多元回归显示年龄增长、心率加快、体重指数大、血压高和男性是舒张功能减退的独立因素，左室质量指数进入多元回归方程，结论：决定健康人左室舒张功能的因素是年龄、心率、体重指数，血压和性别而不是左室质量。     

Cardiac function in fetuses with intracardiac echogenic foci.

OBJECTIVE: To evaluate cardiac dimensions and function in euploid fetuses with intracardiac echogenic foci. STUDY DESIGN: Forty-eight fetuses with a single cardiac echogenic focus situated in the left ventricle had echocardiography performed at 22-24 weeks of gestation. Fifty normal fetuses at 22-24 weeks' gestation served as controls. Two-dimensional and M-mode directed fetal echocardiography were used to exclude cardiac anomalies and measure right and left ventricular free walls and interventricular septal thickness and ventricular systolic and diastolic dimensions. Cardiac size was expressed as a ratio of ventricular wall thickness/biparietal diameter, and cardiac function was expressed as ventricular shortening fraction. Doppler fetal echocardiography measurements included pulmonary and aortic maximum systolic velocities and time to peak velocities as indices of ventricular systolic function, and the ratio between early ventricular filling (E-wave) and active atrial filling (A-wave) peak velocities at the level of the atrioventricular valves as an index of ventricular diastolic function. RESULTS: Early ventricular filling/active atrial filling peak velocity ratios were significantly lower in fetuses with intracardiac echogenic foci than in control fetuses. In the mitral valve the ratio was 0.37 +/- 0.14 (0.039) (mean +/- SD (95% confidence interval for difference between the means)) vs. 0.59 +/- 0.19 (0.052) and in the tricuspid valve it was 0.42 +/- 0.16 (0.045) vs. 0.62 +/- 0.21 (0.058). No significant differences were found in cardiac dimensions, ventricular shortening fraction and Doppler systolic indices. CONCLUSION: Euploid fetuses with intracardiac echogenic foci show low E/A ratio values in midtrimester echocardiography. This finding might indicate cardiac diastolic dysfunction.     

Reference ranges for fetal venous and atrioventricular blood flow parameters.

This cross-sectional study establishes reference ranges with gestation for Doppler parameters of fetal venous and atrioventricular blood flow. Color flow Doppler was used to examine 143 normal singleton pregnancies at 20-40 weeks' gestation. Flow velocity waveforms were recorded from the ductus venosus, right hepatic vein and inferior vena cava. The waveforms are triphasic, reflecting ventricular systole, early diastole and atrial contraction. Peak velocities for these parameters were measured with pulsed Doppler and a new index, the peak velocity index for veins (PVIV), was calculated. Similarly, time-averaged maximum velocities for the whole cardiac cycle were measured and the pulsatility index for veins (PIV) was calculated. Flow velocity waveforms were also recorded at the level of the atrioventricular valves and the ratios of peak velocities at early diastolic filling (E) and atrial contraction (A) were calculated. Regression analysis was used to define the association of each measured and calculated Doppler parameter with gestational age. Blood flow velocities in the fetal veins and velocities and E/A ratios across the atrioventricular valves increased significantly with gestation, whereas PVIV and PIV decreased. Blood flow velocities were highest in the ductus venosus and lowest in the right hepatic vein, and PVIV and PIV were highest in the hepatic vein and lowest in the ductus venosus. In the ductus venosus, there was always forward flow throughout the heart cycle, whereas in the inferior vena cava and hepatic vein during atrial contraction, flow was away from or towards the heart or there was no flow. Pulsatility of flow velocity waveforms in the venous system is the consequence of changes in pressure difference between the venous system and the heart during the heart cycle. The finding that PVIV and PIV decrease with gestation is consistent with decreasing cardiac afterload and maturation of diastolic ventricular function.     

Association of newer diastolic function parameters with age in healthy subjects: a population-based study.

OBJECTIVES: We sought to determine if newer Doppler diastolic function parameters are associated with age and to define age-stratified reference ranges for these parameters in a population-based setting. BACKGROUND: Although newer Doppler parameters aid in the evaluation of diastolic function and filling pressures, age-specific reference ranges are poorly described. METHODS: Randomly selected residents of Olmsted County, Minn, age >/= 45 years were studied (n = 2042) prospectively. Those without a history of cardiovascular disease or abnormal 2-dimensional echocardiograms were selected. Measured parameters included the transmitral early (E) and late (A) filling velocities at rest and with Valsalva, A duration, pulmonary venous atrial reversal duration, lateral and septal early diastolic mitral annular velocities, E/lateral early diastolic mitral annular velocity, E/septal early diastolic mitral annular velocity, and the index of left ventricular myocardial performance. RESULTS: A total of 1012 subjects met the inclusion criteria. Both A duration (r = 0.18, P <.001) and pulmonary venous atrial reversal duration (r = 0.28, P <.001) were longer in older subjects, whereas their difference showed a marginal correlation with age (r = 0.07, P =.036). The E/A ratio at peak Valsalva correlated with age (r = -0.54, P <.001) whereas the change in E/A with Valsalva (corrected for E-A fusion) showed a marginal correlation with age (r = 0.08, P =.032). Both E/lateral early diastolic mitral annular velocity (r = 0.39, P <.001) and E/septal early diastolic mitral annular velocity (r = 0.27, P <.001) increased with age. Left ventricular myocardial performance showed a marginal correlation with age (r = 0.08, P =.014). Age specific reference ranges (median, 5th and 95th percentiles) for all parameters are provided. CONCLUSIONS: All newer Doppler diastolic function parameters showed a variable but significant correlation with age. Age-specific reference values will aid in the interpretation of diastolic function parameters.     

多普勒组织成像鉴别陈旧性心肌梗死患者舒张功能假性正常

目的 探讨应用多普勒组织成像（DTI）检测二尖瓣环舒张期运动速度可否鉴别陈旧性心肌梗死（OMI）患者舒张功能假性正常。 方法 OMI舒张功能假性正常患者68例，正常对照组50例，应用脉冲多普勒（PWD）分别测量二尖瓣口舒张早期峰值流速（E）、舒张晚期峰值流速（A）、E／A、E峰减速时间（DT）、左室等容舒张时间（IRT）、肺静脉收缩波（S）、舒张波（D）、S／D及心房收缩波（Ar）；转换DTI速度模式，测量左室侧壁缘二尖瓣环舒张早期运动峰值速度（Ea）、舒张晚期运动峰值速度（Aa）并计算Ea／Aa。 结果 OMI舒张功能假性正常患者与正常人的年龄和血流频谱E、A、E／A、IRT、D、S／D及二尖瓣环Aa测值比较无显著性差异（P〉0.05），DT缩短和S波降低具有显著性差异（P〈0．05），肺静脉血流Ar较正常人升高，而二尖瓣环Ea及Ea／Aa较比正常人明显减低，具有显著性差异（P〈0．01）。 结论 DTI检测二尖瓣环Ea及Ea／Aa比值可鉴别OMI患者舒张功能假性正常。     

Longitudinal ventricular function: normal values of atrioventricular annular and myocardial velocities measured with quantitative two-dimensional color Doppler tissue imaging.

OBJECTIVE: Quantitative 2-dimensional color Doppler tissue imaging is a new method to reveal impairment of left ventricular (LV) and right ventricular (RV) longitudinal function, which is a potential marker of early myocardial disease. The aim of this study was to obtain normal values for atrioventricular annular and regional myocardial velocities using this method. METHODS: A total of 123 healthy patients (age range: 22 to 89 years) underwent echocardiography including color Doppler tissue imaging using a scanner (Vivid 5, GE Vingmed, Horten, Norway) with postprocessing analysis (Echopac 6.3, GE Vingmed). Regional myocardial velocities were measured at 12 LV segments in 3 apical views and 2 segments of the free RV wall. Mitral annular velocities from 6 sites, and tricuspid annular velocities at its lateral site, were also assessed. At each site, systolic (S(m)), early diastolic (E(m)), and late diastolic (A(m)) velocities were measured, and the E(m)/A(m) ratio was calculated. RESULTS: Patients were classified into 4 groups aged 20 to 39, 40 to 59, 60 to 79, and >/=80 years. Mitral annular velocity and regional LV myocardial S(m) and E(m) progressively decreased with age. A(m), whereas low in the youngest age group, increased significantly in patients more than 40 years of age. The E(m)/A(m) ratio gradually declined with aging. There were no differences between age groups in S(m) measured at the tricuspid annulus and free RV wall, but the pattern of age-related changes of diastolic velocities and E(m)/A(m) ratio was the same as in the LV. Slight but significant sex-related differences were observed in middle-aged groups. The intraobserver and interobserver reproducibility was highest for atrioventricular annular velocities. CONCLUSIONS: A progressive decrease in S(m) reveals a decline in longitudinal systolic LV function with age, whereas systolic RV function remains unaffected. Atrioventricular annular velocity and regional E(m) decrease with aging in both ventricles, suggesting a deterioration in the diastolic properties of the myocardium, whereas A(m) increases from middle age implying a compensatory augmentation of atrial function. The study results can be used as reference data for the quantitative assessment of longitudinal LV and RV function in patients with cardiac disease.     

Assessment of left ventricular function using mitral annular velocities in patients with congestive heart failure with or without the presence of significant mitral regurgitation.

Myocardial velocities in patients with congestive heart failure (CHF) were studied using pulsed wave Doppler tissue imaging. Velocities were recorded at the mitral and tricuspid annulus. Four sites at the mitral annuli were selected corresponding to the septal, lateral, inferior, and anterior walls of the left ventricle from apical 4- and 2-chamber views. A mean value from the above 4 sites was selected to describe the mitral annular velocities. Only one site of the tricuspid annulus was selected, corresponding to the right ventricular free wall. Three different annular velocities were recorded: the peak systolic, and the peak early and late diastolic velocities. A total of 96 patients were compared with 12 age-matched healthy participants. Patients with CHF had significantly decreased mitral and tricuspid systolic velocities compared with healthy participants (4.9 vs 9.3 cm/s, P <.001, for the mitral annulus and 10.4 vs 14.6 cm/s, P <.001, for the tricuspid annulus). The early diastolic velocity was also reduced in patients compared with healthy participants (5.9 vs 10.9 cm/s, P <.001, for the mitral annulus and 8.6 vs 12.9 cm/s, P <.001, for the tricuspid annulus). Patients with CHF had a severely depressed left ventricular ejection fraction (EF) (27%). The correlation the between systolic mitral annular velocity and EF was relatively good (r = 0.59 and P <.001). The patients with CHF were divided into 2 subgroups depending on the presence or absence of significant mitral regurgitation. There was a correlation between EF and the systolic mitral annular velocity both in patients with (r = 0.61, P <.001) and without (r = 0.59, P <.001) significant mitral regurgitation. In conclusion, compared with healthy participants, the mitral and tricuspid annular velocities are significantly decreased in patients with CHF. The correlation between EF and the systolic mitral annular velocity is relatively good irrespective of the presence or absence of significant mitral regurgitation. Measurements of annular velocities constitute a simple and useful method for evaluating patients with CHF.     

Fetal cardiac performance in uncomplicated and well-controlled maternal type I diabetes.

OBJECTIVE: To study the impact of well-controlled, uncomplicated maternal diabetes on fetal cardiac development and performance. METHODS: The following variables were studied in 45 fetuses of type I diabetic women by means of mid- and late-trimester echocardiography: interventricular septal thickness; aortic and pulmonary valve diameters; peak and time-to-peak flow velocity of the great arteries; the ratio between peak velocities during early (E) and late (A) ventricular filling at the level of the atrioventricular values; ventricular fractional shortenings; and output. The findings were compared to age-matched control groups of normal fetuses. RESULTS: A significant augmentation of interventricular septal thickness was demonstrated for mid-trimester fetuses of diabetic women, which progressed further towards the end of pregnancy. However, the indices of diastolic and systolic function remained comparable between the gestational age-matched groups. CONCLUSION: Progressive myocardial thickening occurs commonly in mid- and late-trimester fetuses of uncomplicated and well-controlled diabetic pregnancies. The observed degree of hypertrophy is generally mild and does not affect age-related changes in fetal cardiac function.     

二维彩色多普勒超声心动图评定左室舒张功能

本文用彩色多普勒超声心动图检测100例(20～76岁)正常人舒张功能,按低龄(20～35岁)、中龄(36～50岁)、高龄(>51岁)分为三组。测量二尖瓣多普勒血流频谱①EA 两峰时间—速度积面(T—A);②分别测量 E、A 峰时间—速度积面(F—A)、(A—A)及舒张期前1/2时间—速度积面(50%)(T—A)。心尖四腔或左室二腔切面测量舒张末期左室容积(V)或左室长轴切面、M 型取腱索水平测舒张末期最大内径及二尖瓣短轴切面的(?)口面积。计算下列7项指标。(1)峰值充盈速率(ml/s)PFR;(2)校正峰值充盈速率(Sec~(-1))NPFR;(3)半充盈分数1/2 FF;(4)舒张早期快速充盈的减速度(cm/s~2)DEF;(5)A 峰值速度/E峰值速度 A/E;(6)A 峰时间—速度积面/E 峰时间—速度积面 A—A/E—A;(7)A 峰时间—速度积面/总积面 A—A/T—A。上述所测数据,发现正常人左室舒张功能随年龄增长而改变。舒张早期与 E 峰有关测值随年龄增长而降低(PFR、NPFR、1/2 FF、DEF);舒张晚期与 A 峰有关测值随年龄增长而升高(A/E、A—A/E—A、AA/T—A)。经统计学处理后各组值间有显著差异或非常显著差异(P<0.05或0.001)这一特征与创伤性检查相一致。说明正常人左室舒张功能和顺应性有随着年龄增长而有“衰变”的趋势,这一“衰变”在50岁以上显得明显。多普勒测量左室舒张功能比 M 型敏感。     

Tei指数和组织多普勒联合N端B型钠尿肽前体评价右心早期放射性损伤

目的探讨Tei指数和组织多普勒成像(TDI)联合N端B型钠尿肽前体(NT-proBNP)评价胸部肿瘤患者放疗后右心早期损伤的价值。方法对21例接受胸部全程放疗的胸部肿瘤患者,于放疗前、放疗后1天和1个月行NT-proBNP和超声心动图检查,检查指标:①Tei指数;②常规指标,包括三尖瓣血流舒张早期峰值流速(E)、心房收缩期峰值流速(A)、E/A和E峰减速时间;右心室舒张末期内径和右心房收缩末期内径,右心室面积变化率及三尖瓣瓣环运动幅度;③TDI:三尖瓣环内侧和外侧处收缩期峰值速度(Sa)、舒张早期峰值速度(Ea)、舒张晚期峰值速度(Aa)及E/Ea。结果与放疗前相比,NT-proBNP在放疗后1天明显升高(P<0.05),放疗后1个月降低;放疗后Tei指数升高,Sa、Ea减低,Aa和E/Ea均升高;常规指标在放疗前后无明显变化。结论胸部肿瘤患者放疗后出现右心功能早期轻度损伤;Tei指数、DTI联合NT-proBNP可对其进行评价。     

房室瓣环位移评价心室发育不良胎儿心功能的临床价值研究

目的应用M型超声心动图测量中晚孕胎儿房室瓣环位移（AVAD),探讨AVAD评价心室发育不良胎儿心功能的价值。 方法（1）选取150例孕龄19~41周的正常中晚孕胎儿,应用M型超声心动图测量AVAD［包括二尖瓣瓣环位移（MAD）和三尖瓣瓣环位移（TAD）］及左心室射血分数（LVEF）、左心室短轴缩短率（LVFS）;二维超声画迹法测量右心室舒张末期面积（RVEDA）及收缩末期面积（RVESA）,计算右心室面积变化率（RVPCA）;频谱多普勒（PW）取房室瓣口血流流速曲线,测量E、A峰值流速;组织多普勒（TDI）取房室瓣瓣环的运动流速曲线,分别测量房室瓣环舒张早期峰值流速（Em）、舒张晚期峰值流速（Am）及收缩期峰值流速（Sm）。定量分析AVAD与孕周（GA）及常规心室功能参数间的相关性。（2）选取49例心室发育不良胎儿（其中左心室发育不良组23例,右心室发育不良组26例）,随机选择上述150例正常胎儿中的30例为对照组,应用M型超声心动图测量其AVAD,并比较3组的差别。 结果（1）正常中晚孕胎儿AVAD随GA增加而增长,AVAD与E、A及Em、Am、Sm呈正相关,其中MAD与E、A、Em、Am、Sm呈正相关（r=0.347、0.290、0.407、0.393、0.517,P均<0.01）,TAD与E、A、Em、Am、Sm呈正相关（r=0.351、0.320、0.497、0.403、0.598,P均<0.01）;MAD与LVEF、LVFS无相关性（r=0.199、0.258,P均>0.05）,TAD与RVPCA呈正相关（r=0.837,P<0.01）。（2）左心室发育不良组的MAD较对照组减小［（7.11±0.56）mm vs（7.80±0.87）mm］、TAD较对照组增大［（9.78±2.11）mm vs （9.38±1.51）mm］,差异均有统计学意义（t=2.98、2.47,P均<0.05）;右心室发育不良组的MAD较对照组增大［（8.35±0.69）mm vs （7.80±0.87）mm］、TAD较对照组减小［（7.98±1.69）mm vs（9.38±1.51）mm］,差异均有统计学意义（t=2.42、4.18,P均<0.05）。 结论AVAD是评价胎儿心室长轴功能有价值的参数,可有效评估心室发育不良胎儿的心功能,并有助于此类胎儿的产前咨询。     

Characteristics of mitral and tricuspid annular velocities determined by pulsed wave Doppler tissue imaging in healthy subjects.

Assessment of myocardial velocities by Doppler tissue imaging is gaining in importance. However, generally accepted reference values are still missing. In this study we examined 62 consecutive healthy subjects (mean age 46, range 22-82 years) by pulsed wave Doppler tissue imaging to characterize the systolic and diastolic velocity profiles of the left and right ventricles. The subjects were divided into 3 different age-groups: group I, younger than 40 years; group II, 40 to 59 years; and group III, 60 years and older. Recordings were made along the long axis in the apical 4- and 2-chamber views by using 4 sites (septal, anterior, lateral, and inferior) at the mitral annulus and 1 site at the tricuspid annulus. Systolic mitral annular velocity (10.3 +/- 1.4 cm/s) correlated strongly with global left ventricular function determined by M-mode echocardiographic mitral annular displacement (r = 0.70, P <.001). The systolic velocity was significantly lower in group III than in group I (9.6 vs 10.8 cm/s, P <.01). A relatively weak, but significant, correlation was found between systolic velocity and the age of the subjects (r = -0.43, P <.001). Mitral annular early diastolic velocity was also lower in group III compared with group I (11.3 vs 17.7 cm/s, P <.001), with a strong correlation with age (r = -0.81, P <.001) and other conventional Doppler diastolic parameters. Both the systolic and early diastolic mitral annular velocities at the septum were lower than at other left ventricular sites. Tricuspid annular systolic velocity (15.2 +/- 1.9 cm/s) was higher than mitral annular systolic velocity (P <.001). Unlike mitral annular velocity, systolic tricuspid annular velocity was not correlated with age. However, the diastolic tricuspid annular velocities correlated well with transtricuspid Doppler diastolic parameters. The method of recording the annular velocities was feasible in all subjects, simple and highly reproducible.     

Tissue Doppler echocardiography and myocardial performance index in patients with scleroderma

In this study, left and right ventricular functions were examined echocardiographically in 22 patients with scleroderma and 22 healthy volunteers. Conventional and tissue Doppler echocardiography and myocardial performance indexes were used as measures of right and left ventricular global functions. Mitral early diastolic E wave deceleration time, isovolumetric contraction time and left ventricular myocardial performance index and peak tricuspid A wave velocity were significantly higher in the scleroderma group compared with the control group. Mitral and tricuspid E/A ratios were significantly lower in patients with scleroderma. In addition, mitral annular and tricuspid annular isovolumetric relaxation times and the tricuspid E/E' ratio were significantly increased in scleroderma patients compared with the control group. In conclusion, in scleroderma patients the global left ventricular functions were depressed and diastolic function abnormalities were seen in both right and left ventricles. In addition, longitudinal muscle functions of the ventricles were depressed in scleroderma patients, as shown by tissue Doppler imaging parameters.     

心脏移植术后多普勒超声心动图动态监测

目的 观察心脏移植术后心脏各房、室腔大小,室壁厚度,二、三尖瓣血流频谱。方法 应用Acuson多普勒超声心动图诊断仪,对10例心脏移植患者进行术后6个月随访观察,采用M型超声观察室壁厚度,B型超声观察各房室腔大小,脉冲多普勒观察二、三尖瓣血流频谱。结果 心脏移植术后主要表现为右房、室内径增大,心室壁及室间隔增厚,而二、三尖瓣血流频谱则显示为二尖瓣血流E、A峰流速的减慢。结论 心脏移植术后会发生一系列不同于正常心脏的变化过程,了解这一变化情况有助于判断急性排异反应的发生。     

心室功能评估中房室瓣环组织多普勒波形的测定

在诸多无创性评估心室功能的检测手段和方法中,多普勒组织成像(DTI)正得到临床的广泛应用,房室瓣环组织多普勒波形改变对心室功能的提示意义也逐渐受到重视.房室瓣环的运动代表了心肌纤维由基底部向心尖的运动,瓣环运动速度的测定可提供心室收缩期到舒张早期运动状态的信息.DTI获得的二尖瓣环收缩期运动速度波形可反映心梗缺血壁段引起的左室壁不协调性,并可用这些参数评价左室的整体收缩功能.三尖瓣环的DTI运动速度可以用于评价与下壁心梗相关的右室功能.因受前负荷变化的影响小,二尖瓣环DTI有助于鉴别二尖瓣的假阴性血流频谱,有助于无创性评估左室充盈压.一些影响房室瓣环DTI运动速度测定的因素目前难以消除,需结合其他多普勒参数和临床表现来分析.     

组织多普勒成像对正常胎儿房室环运动的研究

目的　探讨组织多普勒成像 (TDI)检测胎儿房室环的运动特征及其随孕龄变化情况的可行性。方法　应用TDI技术的彩色二维和脉冲方式观察 6 7例正常胎儿四腔心切面的二、三尖瓣环运动 ,测量其收缩、舒张期运动的峰值速度 ;用传统多普勒显像测量舒张期二、三尖瓣口血流峰值速度 ,并与舒张期房室环的运动测值进行比较。结果　二、三尖瓣环收缩期及舒张早期峰值速度均随孕龄显著增大 ,舒张早、晚期房室环运动峰值速度之比 (Ea/Aa)亦随孕龄显著增大 ,舒张晚期二、三尖瓣环峰值速度随孕龄增加的幅度较小 ;二尖瓣环的峰值速度明显小于三尖瓣环 (P <0 .0 1) ;Ea/Aa与瓣口血流峰值速度之比E/A相关性较好。结论　TDI可用于检测胎儿二、三尖瓣环的运动及其随孕龄的变化 ,并可作为一种新的评价胎儿心功能的方法。     

不同孕周胎儿心脏结构及其心功能的相关参数的分析

[目的]探讨不同孕周胎儿心脏结构及其心功能的相关参数.[方法]应用彩色多普勒超声心动图检测不同孕周孕妇216例,比较不同孕周胎儿心腔径线、瓣膜口峰值血流速度、射血分数和Tei指数.[结果]胎儿时期心脏各腔室大小随着孕周的增长而增大,右室大于左室,结构上右室占优势;各瓣口峰值血流速度随胎龄增加而升高,二尖瓣小于三尖瓣,主...     

慢性肺心病对左心室舒张功能的影响

评价慢性肺源性脏病对左心功能的影响,方法采用ＵＣＧ技术对３０例肺心病患者左心功能进行研究,并与同年龄组正常人进行对照。结果显示肺心病患者组左心室舒张早期充盈率与Ｅ峰减速率明显低于对照组,而左心室舒张晚期充盈率,舒张晚期与舒张早期充盈率的比值则明显高于对照组,肺心病组左心病射血分略高于对照组,每搏排血量测显著减低,结论：肺心病患者存在明显的左心室舒张功能障碍。     

Abnormal cardiac function in fetuses with increased nuchal translucency.

OBJECTIVE: To evaluate cardiac function in structurally and chromosomally normal fetuses with increased nuchal translucency (NT). METHODS: Forty-two structurally and chromosomally normal fetuses with increased NT at 11-14 weeks of gestation underwent fetal echocardiographic examination at 20-23 weeks. Fifty fetuses with normal NT values were considered as controls. Pulmonary and aortic peak velocity and time to peak velocities were measured as indices of ventricular systolic function. The ratios between the E-wave and A-wave (E/A) and the ratios between the E-wave and time velocity integral (E/TVI) at the level of both atrioventricular valves were evaluated as indices of ventricular diastolic function. RESULTS: In fetuses with increased NT the E/A ratios were significantly decreased when compared to control fetuses at the level of both the mitral (0.52 +/- 0.09 vs. 0.60 +/- 0.10, P = 0.0002) and tricuspid (0.51 +/- 0.09 vs. 0.61 +/- 0.09, P < 0.0001) valves. Similar results were found for the E/TVI ratios (mitral valve 4.79 +/- 1.03 vs. 5.63 +/- 1.23, P = 0.0007 and tricuspid valve 4.40 +/- 0.88 vs. 5.19 +/- 0.82, P < 0.0001). No significant relationship was found between the degree of NT and the abnormalities in Doppler indices. There were no significant differences in Doppler systolic indices. CONCLUSION: Structurally and chromosomally normal fetuses with increased NT have low E/A and E/TVI ratios at 20-23 weeks of gestation. These findings might indicate cardiac diastolic dysfunction.