Echocardiography is the most common diagnostic method for assessing cardiac function but some limitations affect this technique.Until now,visual assessment of wall motion and thickening has allowed only a subjective e...Echocardiography is the most common diagnostic method for assessing cardiac function but some limitations affect this technique.Until now,visual assessment of wall motion and thickening has allowed only a subjective evaluation of myocardial function and requires long-term training.Recently,new echocardiographic techniques have been introduced to evaluate myocardial mechanics.Tissue Doppler imaging(TDI)technique is limited by angle-dependency such that only deformation along the ultrasound beam can be derived from velocities,while myocardium deforms simultaneously in three dimensions.Speckle tracking echocardiography (STE)is a more recent technique that provides a global approach to left ventricular myocardial mechanics,giving information about the three spatial dimensions of cardiac deformation.In this editorial,we describe the physical and pathophysiological concepts of STE,discussing the differences compared to TDI and underlining the pitfalls of this new technique.展开更多
Background Tissue Doppler imaging （TDI） has provided an objective means to quantify global and regional left ventricular （LV） and right ventricular （RV） function with improved accuracy and greater reproducibilit...Background Tissue Doppler imaging （TDI） has provided an objective means to quantify global and regional left ventricular （LV） and right ventricular （RV） function with improved accuracy and greater reproducibility than conventional echocardiography. This study was conducted to assess RV myocardial systolic activation by TDI in subjects with pulmonary arterial hypertension （PAH）. Methods A total of 30 patients with PAH and 30 healthy volunteers, all comparable in age and sex, underwent standard Doppler echo and TDI. Using pulsed Doppler echocardiography combined with TDI, the following regional parameters were evaluated in three different myocardial segments （RV basal lateral wall, basal septal, and LV basal lateral） on apical 4-chamber view： systolic （Sm）, early- and late-diastolic （Em and Am） peak velocities. RV myocardial systolic activation delay was defined as the difference in time to peak TDI systolic velocities between the RV basal lateral wall and basal septal. In addition, RV end-diastolic and end-systolic areas were measured to calculate RV fractional area change from the same apical 4-chamber view. Results Compared with the control group, patients with PAH showed increased RA and RV end-diastolic diameter （RA： （4.5±1.2）cm vs （3.0±0.8）cm, P〈0.05 and RV： （4.8±1.9）cm vs （3.4±0.5）cm, P〈0.05） and reduced RV fractional area change; （35±14）% vs （56±9）%, P〈0.05. These PAH patients showed lower myocardial peak velocities and a significant activation delay compared with controls （P〈0.05）. Moreover, a strong correlation between RV myocardial systolic activation delay and RV fractional area change was shown in patients with pulmonary arterial hypertension （r = -0.82）. Conclusions In PAH, RV myocardial systolic activation was markedly delayed, which was directly related to the RV fractional area change. RV myocardial systolic activation delay assessed by TDI could offer a unique approach to predict RV dysfunction.展开更多
目的:探讨组织多普勒成像(tissue Doppler imaging,TDI)Tei指数在评价慢性阻塞性肺病(chronic obstructive pulmonary disease,COPD)患者右心室功能中的价值。方法:选择临床确诊为COPD的患者38例,同时选取健康对照组20例,均行二维超声...目的:探讨组织多普勒成像(tissue Doppler imaging,TDI)Tei指数在评价慢性阻塞性肺病(chronic obstructive pulmonary disease,COPD)患者右心室功能中的价值。方法:选择临床确诊为COPD的患者38例,同时选取健康对照组20例,均行二维超声心动图,测量右心常规超声指标,并利用TDI技术测量、计算右心室Tei指数。结果:38例COPD患者中,17例患者有慢性肺源性心脏病典型的心脏形态改变,右心房最大横径(the maximum diameter of right atrium,RA)为(4.8±0.4)cm,右心室基底段横径(the diameter of right ventricle,RV)为(4.2±0.1)cm,右心室前壁厚度(the thickness of the front wall of right ventricle,RVAW)为(0.6±0.2)cm,肺动脉收缩压(pulmonary artery systolic pressure,PASP)为(82±17)mmHg,与对照组比较[(3.2±0.6)cm、(2.8±0.4)cm、(0.3±0.1)cm和(12±4)mmHg]差异有统计学意义(P<0.05);右心室Tei指数为0.70±0.08,与对照组比较(0.41±0.07)差异有统计学意义(P<0.05)。21例患者有轻度肺动脉高压而无右心形态改变,其RA、RV和RVAW与对照组比较差异无统计学意义(P>0.05);PASP为(43±11)mmHg,与对照组比较差异有统计学意义(P<0.05);右心室Tei指数为(0.61±0.11),与对照组比较差异有统计学意义(P<0.05)。但2组COPD患者右心室Tei指数比较差异无统计学意义(P>0.05)。结论:TDI右心室Tei指数能准确有效地评价COPD患者的右心室功能,具有较好的临床应用价值。展开更多
文摘Echocardiography is the most common diagnostic method for assessing cardiac function but some limitations affect this technique.Until now,visual assessment of wall motion and thickening has allowed only a subjective evaluation of myocardial function and requires long-term training.Recently,new echocardiographic techniques have been introduced to evaluate myocardial mechanics.Tissue Doppler imaging(TDI)technique is limited by angle-dependency such that only deformation along the ultrasound beam can be derived from velocities,while myocardium deforms simultaneously in three dimensions.Speckle tracking echocardiography (STE)is a more recent technique that provides a global approach to left ventricular myocardial mechanics,giving information about the three spatial dimensions of cardiac deformation.In this editorial,we describe the physical and pathophysiological concepts of STE,discussing the differences compared to TDI and underlining the pitfalls of this new technique.
文摘Background Tissue Doppler imaging （TDI） has provided an objective means to quantify global and regional left ventricular （LV） and right ventricular （RV） function with improved accuracy and greater reproducibility than conventional echocardiography. This study was conducted to assess RV myocardial systolic activation by TDI in subjects with pulmonary arterial hypertension （PAH）. Methods A total of 30 patients with PAH and 30 healthy volunteers, all comparable in age and sex, underwent standard Doppler echo and TDI. Using pulsed Doppler echocardiography combined with TDI, the following regional parameters were evaluated in three different myocardial segments （RV basal lateral wall, basal septal, and LV basal lateral） on apical 4-chamber view： systolic （Sm）, early- and late-diastolic （Em and Am） peak velocities. RV myocardial systolic activation delay was defined as the difference in time to peak TDI systolic velocities between the RV basal lateral wall and basal septal. In addition, RV end-diastolic and end-systolic areas were measured to calculate RV fractional area change from the same apical 4-chamber view. Results Compared with the control group, patients with PAH showed increased RA and RV end-diastolic diameter （RA： （4.5±1.2）cm vs （3.0±0.8）cm, P〈0.05 and RV： （4.8±1.9）cm vs （3.4±0.5）cm, P〈0.05） and reduced RV fractional area change; （35±14）% vs （56±9）%, P〈0.05. These PAH patients showed lower myocardial peak velocities and a significant activation delay compared with controls （P〈0.05）. Moreover, a strong correlation between RV myocardial systolic activation delay and RV fractional area change was shown in patients with pulmonary arterial hypertension （r = -0.82）. Conclusions In PAH, RV myocardial systolic activation was markedly delayed, which was directly related to the RV fractional area change. RV myocardial systolic activation delay assessed by TDI could offer a unique approach to predict RV dysfunction.
文摘目的:探讨组织多普勒成像(tissue Doppler imaging,TDI)Tei指数在评价慢性阻塞性肺病(chronic obstructive pulmonary disease,COPD)患者右心室功能中的价值。方法:选择临床确诊为COPD的患者38例,同时选取健康对照组20例,均行二维超声心动图,测量右心常规超声指标,并利用TDI技术测量、计算右心室Tei指数。结果:38例COPD患者中,17例患者有慢性肺源性心脏病典型的心脏形态改变,右心房最大横径(the maximum diameter of right atrium,RA)为(4.8±0.4)cm,右心室基底段横径(the diameter of right ventricle,RV)为(4.2±0.1)cm,右心室前壁厚度(the thickness of the front wall of right ventricle,RVAW)为(0.6±0.2)cm,肺动脉收缩压(pulmonary artery systolic pressure,PASP)为(82±17)mmHg,与对照组比较[(3.2±0.6)cm、(2.8±0.4)cm、(0.3±0.1)cm和(12±4)mmHg]差异有统计学意义(P<0.05);右心室Tei指数为0.70±0.08,与对照组比较(0.41±0.07)差异有统计学意义(P<0.05)。21例患者有轻度肺动脉高压而无右心形态改变,其RA、RV和RVAW与对照组比较差异无统计学意义(P>0.05);PASP为(43±11)mmHg,与对照组比较差异有统计学意义(P<0.05);右心室Tei指数为(0.61±0.11),与对照组比较差异有统计学意义(P<0.05)。但2组COPD患者右心室Tei指数比较差异无统计学意义(P>0.05)。结论:TDI右心室Tei指数能准确有效地评价COPD患者的右心室功能,具有较好的临床应用价值。
