The Clinical Study Of Doppler Echocardiography In The Assessment Of Left Ventricular Diastolic Function

Part 1 The Study of Left Ventricular Diastolic Function Using Doppler echocardiogram in Healthy Persons With Different AgeObjectives To Investigate the decreasing tendency and influencing factors of the ventricular diastolic function with Doppler Echocardiogram in healthy persons, and find changes with aging.Methods Doppler echocardiogram was performed in 431 healthy subjects with different age in Beiking, The subjects were divided into six groups according to their ages ,and five groups according to their heart rates.The mitral and pulmonary venous flow were measured by pulsed Doppler echocardiolgram including peak flow velocity of early diastole(E Epeak ),peak flow velocity of atrial contraction (Apeak), E/A ratio , EDT , pulmonary venous flow velocity of systole ( PVS), pulmonary venous flow velocity of diastole (PVD) , pulmonary venous atrial reversal flow velocity (Ar) and duration (DAr).Doppler tissue imaging was performed from each of four mitral annular sites: septal (MVA-S) and lateral (MVA-L) from apical 4-chamberviews, anterior (MVA-A) and inferior (MVA-I) from apical 2-chimberviews, the mean value from the above sites were calculated including peak flow velocity of early systole (Sm),peak flow velocity of early diastole (Em) , peak flow velocity of atrial contraction(Am) , Em/Am ratio and IVRT .Results With increasing age, the peak flow velocity of early diastole(Epeak), pulmonary venous flow velocity of diastole (PVD) and the mean value of peak flow velocity of early diastole (Em) significantly decreased (p=0.000<0.01) ; while the peak flow velocity of atrial contraction (Apeak ), the mean value of peak flow velocity of atrialcontraction(Am) and pulmonary venous atrial reversal flow velocity (Ar) significantly increased(p=0.000<0.01); E/A ratio and Em/Am ratio significantly decreaded (p=0.000<0.01); EDT, DAr and IVRT significantly elongated (p=0.000<0.01). With increasing heart rate , the mean value of peak flow velocity of atrial contraction(Am) increased (p=0.006<0.01) ; E/A ratio (p=0.0258<0.05) and Em/Am ratio (p=0.0095<0.01 ) decreased. General analysis data criteria had been established .Conclusions Those variables including Epeak, Apeak, E/A ratio, Em, Am and Em/Am ratio et al have close correlations with aging, can be used to evaluate left ventricular diastolic function and also can be considered as markers to assessment aging. Besides age, the heart rate is also a important factor in evaluating left vertricular diastolic function.Part 2 The Clinical Study of Left Ventricular Allomeric Function With Tissue Doppler Imaging in Patients of Myocardial infarctionObjectives Detecting the left ventricular allomeric function in patients of myocardial infarction with tissue Doppler imaging , to seek variables which have close correlations with the left ventricular allomeric function to use in clinical evaluation.Methods 41 patients of myocardial infarction with various stages of diastolic and systolic dysfunction and 40 normal controls are involved in this study , age from 25~70 years old ,There were male patients 40 ,female 1 (anterior wall myocardial infarction 15, inferior wall or inferior wall with posterior wall myocardial infarction 18, anterior wall and inferior wall or inferior wall with posterior wall myocardial infarction 8 ; lesion in one coronary artery 8, lesion in two coronary artery 13, lesion in three coronary artery 20). Measuring routine variables with echocardiogram (ejection fraction EF was detected with simpson techniche). The mitral flow andpulmonary venous flow were detected by pulsed Doppler echocardiogram including peak flow velocity of early diastole (Epeak), peak flow velocity of atrial contraction (Apeak), E/Aratio , EDT, pulmonary venous flow velocity of systole ( PVS), pulmonary venous flow velocity of diastole (PVD) , pulmonary venous atrial reversal flow velocity (Ar) and duration (DAr).Doppler tissue imaging was performed from each of four mitral annular sites: septal (MAV-S) and lateral (MAV-L) from apical 4-chamberviews, anterior (MVA-A) and inferior (MAV-I) from apical 2-chimberviews, the mean value from the above sites were calculated including peak flow velocity of early systole (Sm), peak flow velocity of early diastole (Em) , peak flow velocity of atrial contraction(Am), Em/Am ratio and IVRT. The patients were divided into 3 groups according their mitral flow spectrum: 1 delayed left ventricular relaxation ;2 pseudonormal left ventricular filling; 3 restrictive left ventricular filling, and into 2 groups according their ejection fraction EF: 1 EF≥50%; 2 EF<50%, all variables were compared with normal controls.Results With the deteriorating of the left ventricular diastolic dysfunction, significant differences were found in Em and Em/Am ratio(p=0.000<0.01) detected by Doppler tissue imaging , especially between the group of normal control and delayed left ventricular relaxation (p=0.000<0.01)and between the group of normal control and pseudonormal left ventricular filling (p=0.001<0.01).Sm, Em and Em/Am ratio were showed to decrease gradually among the groups of normal controls , patients of myocardial infarction with EF ≥ 50%and EF<50%(p=0.000<0.01) .Spearman correlation analysis showed Em and Em/Am ratio have close correlation with left ventricular diastolic function, P s=-0.6907, ρ s=-0.6069 (p=0.000<0.01); line correlation analysis showed Sm has close correlation with EF, R=0.6202 (p=0.000<0.01) .Conclusions The left ventricular diastolic dysfunction usually...