吉田 尚康¹, 岡本 光師², 福原 敏行¹

Naoyasu YOSHIDA¹, Mitsunori OKAMOTO², Toshiyuki FUKUHARA¹

¹広島県立広島病院臨床研究検査科, ²広島県立広島病院循環器内科

¹Department of Laboratory Medicine, Hiroshima Prefectural Hospital, ²Department of Cardiology, Hiroshima Prefectural Hospital

キーワード : aging, atrial function, Doppler tissue imaging, echocardiography

目的：組織ドプラ法における心房収縮期の左房壁収縮速度(以下, LAWV)の測定方法を検討すること. 方法：25-84歳の64人の健常成人を対象として, 速度プロファイル法でLAWVを計測した. 心尖部四腔断面, 心尖部長軸断面, 短軸断面, 長軸断面での左房壁マッピングにより, LAWVの最大値(LAWVmax)を求め, 年齢別変化や, 左房収縮期の左室流入血流肺静脈血流との関係を検討した. 結果：LAWVはサンプルボリュームの位置によって変化し, 弁輪部近くの左房では左室の動態に似ていた. 心房収縮期の動態を観察するのに最適なサンプルリュームは左房の後壁, 頭側であった. 心尖部四腔断面, 心尖部二腔断面, 短軸断面, 長軸断面での検討で, 心尖部二腔断面でのLAWVが最大となる頻度が74%と最も高かった. 各断面で得られたLAWVのうちの最大値LAWVmaxをその健常成人の代表値とすると, 対象全体では平均3.1±0.7 cm/secであった. LAWVmaxは25-84歳までの健常成人では加齢につれて軽度増加傾向は示すもののほぼ一定の値であった. 心房収縮期のLAWVパターンにおける持続時間は112±12 msecであった. この値も健常成人ではほぼ一定の値であった. LAWVmaxと左室流入血流のpeak A, A/E 比, 肺静脈血流の心房収縮期流速PVAとの間には有意な相関関係は得られなかった. 結論：健常成人64名(年齢25-84歳)の左房壁運動速度を組織ドプラ速度プロファイル法で測定した. その値は加齢によって変化せず, また僧帽弁血流, 肺静脈血流の心房収縮期指標とは有意な相関関係を示さなかった.

Purpose. The aim of this study was to find a method for measuring left atrial wall velocity (LAWV) during atrial contraction using tissue Doppler echocardiography. Methods. The velocity profile method was used to measure left atrial wall velocity at several sites in 64 healthy individuals aged 25-84 years. We attempted to find maximum left atrial wall velocity (LAWVmax) by mapping on fourchamber, two-chamber, short-axis, and long-axis views and studied the relations between maximum left atrial wall velocity, age, and peak velocity during atrial contraction in mitral or pulmonary venous flow. Results. Left atrial wall velocity was varied by changing the position of the sampling volume. The velocity profile pattern was similar to the left ventricular wall velocity pattern near the mitral valve annulus in the left atrium. Left atrial wall velocity had a positive peak during atrial contraction when the sample volume was located in the cranial and dorsal area. Maximum left atrial wall velocity was obtained in 74% of cases with the two-chamber view. Maximum left atrial wall velocity in healthy subjects was 3.1賊0.7 cm/s, and the duration of the atrial contraction was 112賊12 ms. Maximum left atrial wall velocity increased slightly with age but was not significantly correlated with peak velocity during atrial contraction in mitral or pulmonary venous flow. Conclusions. Left atrial wall velocity was measured by the velocity profile method in 64 healthy subjects aged 25-84 years. Maximum left atrial wall velocity increased slightly with age but was not significantly correlated with the peak velocity during atrial contraction in mitral or pulmonary venous flow.