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학술저널
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한국심초음파학회 Journal of Cardiovascular Imaging Journal of Cardiovascular Imaging 제22권 제1호
발행연도
2014.1
수록면
23 - 27 (5page)

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Background: A distinct velocity pattern represented by a “notch” is observed during the time interval between the end of thesystolic and the onset of the early diastolic velocity wave on longitudinal myocardial velocity curve. The origin of the post-systolicvelocity notch (PSN) has not been resolved. Methods: The high frame rate color tissue Doppler imaging of the apical longitudinal axis was performed in 32 healthysubjects. Results: The time delays of the PSN onset at the posterior aortic wall (AW), the mid anteroseptal wall (MAS) and theposterior mitral annulus (MA) relatively to the anterior aortic annulus (AA) were found to be significantly longer than zero (5.1 ±2.2, 6.0 ± 2.3, 6.8 ± 2.8 ms; p < 0.001). The amplitude was the highest at the AA when compared to the AW, the MAS and theMA (4.77 ± 1.28 vs. 2.88 ± 1.11, 2.15 ± 0.73, 2.44 ± 1.17 cm/s; p < 0.001). A second PSN spike was identifiable in 10/32(31%) of the studied subjects at the AA. Of these, 9 (28%) exhibited a second PSN spike at the AW, 3 (9%) at the MAS and noone at the MA. Conclusion: The AA represents the site of the earliest onset and maximal amplitude of the PSN on the longitudinal velocitycurve suggesting its mechanism to be that of an energy release at the instant of the aortic valve closure causing an apicallydirected acceleration of the myocardium. A substantial number of healthy subjects exhibit a second PSN spike predominantly atthe level of the AA. Its mechanism remains to be elucidated.

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