Correction Of The Mitral Blood Spectral Parameters To Obtained E/Em For Assessment Of Left Ventricular Diastolic Function By Ultrasonic Dual Pulse-wave Dopple In A Same Heartbeat Period

Objective:Through the dual pulse-wave Doppler required the early diastolic mitral inflow E and early diastolic mitral annular motion Em in the same cardiac cycle, correction of mitral flow gained ratio E/Em, to explore the application value of dual pulse-wave Doppler method for assessment of left ventricular diastolic function.Methods:1.148 subjects recruited, medical history, physical examination,12 lead ECQ echocardiography, blood biochemistry, liver and kidney function tests were normal, were divided into 6 groups, respectively, into group 1:20～ 29 years old、group2:30～ 39 years old、group3:40～ 49 years old、group4:50～ 59 years old、group5:60～ 69 years old、 group6:70～ 87 years old.2. The conventional method to measure cardiac structure parameters of different age groups, with Dual pulse-wave Doppler method and conventional method were respectively measured mitral valve flow spectrum and Doppler spectrum (MVFP) and tissue Doppler imaging (TDI) parameters, and get the E/Em correction.3. With intracardiac catheter measurement of left ventricular end diastolic pressure(LVEDP) and the difference between a comparative analysis to obtain E/Em, to study the application value of Dual pulse-wave Doppler on left ventricular diastolic function assessment.Results:1. With the increase of age, left atrial end systolic area (LAA) increased (P<0.01); age was negatively correlated with E, E/A, Em (P< 0.01), and A, Em was positively related to E/(P<0.01).2. After correction E, A and E/Em, obtained by DPW, is increased than the conventional Doppler method (P<0.01).3. Compared to the traditional Doppler method, the difference was statistically significant, that DPW method obtained correctional E/Em in the>50 age group, which can be more sensitive to reflect the effect of age on left ventricular diastolic function.4.13 Subjects were Checked out by Dual pulse-wave Doppler (of which 1 people without heart catheterization measurements to be excluded, the actual 12 people)and 5 people were detected by the traditional method, those of E/Em≥9.2, who were directly determined the left ventricular end diastolic pressure by retrograde left heart catheterization. Besides,10 of those have the left ventricular end diastolic pressure increased (LVEDP>12mmHg), who has to Coronary angiography, one of those was Coronary heart disease, that is to say, left ventricular diastolic dysfunction.dual pulse-wave Doppler has a higher detection rate of the left ventricular dysfunction.Conclusions:1. compared to the traditional Doppler method, Dual pulse-wave Doppler of measurement E/Em in the same cardiac cycle, can avoid different cardiac cycle hemodynamics and tissue motion changes lead to measurement error of E/Em.2. The blood flow velocity of traditional Doppler ultrasonic measurement actually represents blood relative to the probe movement speed. That dual pulse-wave Doppler gained blood relative to the real velocity of mitral valve by measured and corrected for during a cardiac cycle, can accurately reflect the state of cardiac function.3. Combined with intra-cardiac catheter pressure measurement, E/Em gained by dual pulse-wave Doppler method was more sensitive and accurate to assess the left ventricular diastolic function, and avoid the high false negative rate.