ABSTRACT
Objective To investigate the clinical value , the motive regularity, the temporal and spatial correlation between myocardium and adjacent pericardium of left ventricular short -axis in normal adsults by using dual pulse wave Doppler echocardiography .Methods Tissue dual pulse spectral Doppler images about segmental myocardium and adjacent pericardial of three complete cardiac cycles in 99 normal adults were collected synchronously by using dual pulse wave Doppler techenology ,6 segments were enrolled in this study, including the anterior and posterior wall at mitral valve , papillary muscles, and apex level of left ventricular short-axis view.The motive regularity of myocardium and adjacent pericardium at different levels and segments were observed .Peak speed, onset time and peak time between myocardium and adjacent pericardium in anterior and posterior wall of three valves were measured online in systolic , early diastolic, and late diastolic, and the correlation between segmental myocardium and adjacent pericardium in speed and time were analyzed.Results Dual pulse wave Doppler echocardiography showed that in left ventricular short-axis view, motion between myocardium and adjacent pericardium in the same segment had consistent direction, motions between myocardium and adjacent pericardium in anterior and posterior wall at the same level had opposite directions .Comparison of peak velocity, in anterior wall, the peak velocities of myocardium in systolic and late diastolic at mitral valve level , and the peak velocity of myocardium in systolic at papillary muscle level were lower than that of adjacent pericardium .In posterior wall, the peak velocities of myocardium in early diastolic and late diastolic at mitral valve level , the peak velocities of myocardium in systolic and early diastolic at papillary muscle level , and the peak velocity of myocardium in early diastolic at apex level were higher than that of adjacent pericardium , with statistical significance (t=-4.207, -2.078, 4.575, -2.277, -2.440, -2.292, 5.980, 2.604, all P<0.05).Comparison of onset time, the onset time of myocardium in systolic at papillary muscle level in anterior wall , and the onset time of myocardium in early diastolic at mitral valve level in posterior wall were lower than that of adjacent pericardium, with statistical significance (t =-2.447, -2.020, both P<0.05).Comparison of peak time, except the peak time of myocardium in systolic and early diastolic at mitral valve level in posterior wall was lower than that of adjacent pericardium , the remaining differences were statistically significant ( t =-3.530, -2.411, both P<0.05).Peak velocity, onset times and peak times of each segment measured between myocardium and adjacent pericardium were well correlated (r =0.407 -0.933, all P <0.01). Conclusions Dual pulse wave Doppler echocardiography can provide relativity and accordance between motive velocity and direction of left ventricular myocardium and adjacent pericardium in normal adults .It is a promising new method for the clinical diagnosis of constrictive pericarditis and differentiation with restrictive cardiomyopathy.