Zusammenfassung.
Ziel der vorliegenden Studie war es, den Einfluss des Schlagvolumens (SV) auf die mittels Gewebedoppler (Tissue Doppler Imaging=TDI) abgeleiteten Mitralringgeschwindigkeiten zu untersuchen. Zu diesem Zweck wurden konventionelle echokardiographische Parameter und Mitralringgeschwindigkeiten (S′, E′, A′) bei 14 Patienten mit erhöhtem SV (bei primärer Mitralinsuffizienz (ESV-Gruppe)), bei 41 Patienten mit reduziertem SV (bei ischämischer (n=27) oder dilatativer Kardiomyopathie (n=9) oder hypertensiver Herzerkrankung (n=5) (RSV-Gruppe) und bei 29 asymptomatischen Kontrollprobanden erfasst. Systolische (S′) und frühdiastolische (E′) Mitralringgeschwindigkeiten waren in der ESV-Gruppe im Vergleich zur Kontrollgruppe erhöht, in der RSV-Gruppe erniedrigt. In der linearen Regressionsanalyse bestanden signifikante Beziehungen zwischen SV und systolischer Mitralannulusgeschwindigkeit S′ (r=0,74, p<0,001), SV und frühdiastolischer Mitralannulusgeschwindigkeit E′ (r=0,74, p<0,001) sowie SV und spätdiastolischer Mitralannulusgeschwindigkeit A′ (r=0,41, p<0,01). In der multivariaten Regressionsanalyse war SV ein stärkerer unabhängiger Prädiktor von S′ und E′ als konventionelle systolische oder diastolische echokardiographische Indices. Somit besitzt das Schlagvolumen einen bedeutsamen Einfluss auf systolische (S′) und frühdiastolische (E′) Mitralringgeschwindigkeiten. Dies sollte berücksichtigt werden, wenn Mitralringgeschwindigkeiten zur Beurteilung von systolischer/diastolischer Ventrikelfunktion oder zur Abschätzung von Füllungsdrücken eingesetzt werden.
Summary.
The aim of this study was to assess the impact of stroke volume (SV) on mitral annular velocities derived from tissue Doppler imaging (TDI). To this end, conventional echocardiographic variables and TDI derived mitral annular velocities (S′, E′, A′) were obtained in 14 patients (pts) with increased SV (due to primary mitral (n=12) (ISV group)), in 41 pts with reduced SV (due to ischemic (n=27) or dilated cardiomyopathy (n=9) or hypertensive heart disease (n=5) (RSV group)) and 29 asymptomatic controls with normal SV (CON group). Systolic (S′) and early diastolic (E′) mitral annular velocities were elevated in the ISV group in the comparison to the CON group, but were significantly reduced in the RSV group. Late diastolic annular velocities (A′) did not differ between the ISV and the CON group, but were lowest in the RSV group. On simple linear regression analysis, SV was significantly related to S′ (r=0.74, p<0.001), to E′ (r=0.74, p<0.001) and to A′ (r=0.43, p<0.01). On multiple regression analysis, SV was a stronger independent predictor of S′ and E′ than conventional systolic or diastolic echocardiographic variables. Thus, stroke volume has a significant impact on TDI derived systolic (S′) and early diastolic (E′) mitral annular velocities. This should be considered, when TDI is used in the evaluation of LV performance or in the estimation of filling pressures.
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Bruch, C., Stypmann, J., Gradaus, R. et al. Stroke volume and mitral annular velocities. Z Kardiol 93, 799–806 (2004). https://doi.org/10.1007/s00392-004-0132-y
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DOI: https://doi.org/10.1007/s00392-004-0132-y