연구배경： 도플러 심초음파는 좌심실 이완기 기능 평가에 매우 유용한 임상적인 도구이다. 최근에 좌심실 이완기능의 정확한 평가와 전부하에 비교적 덜 민감한 것으로 알려져 있는 조직 도플러 심초음파와 더불어 색 M형 도플러 심초음파도가 좌심실 이완기 기능의 새로운 평가 방법으로 대두되고 있다. 이에 저자들은 급성 심근경색증을 포함한 관상동맥환자에서 경흉부 심초음파의 색 M형 도플러 심초음파도를 이용한 Vp로 좌심실 이완기 기능을 평가하고 기존의 좌심실 이완기 기능지표와 비교하였다. 방 법： 대상은 1999년 3 월에서 1999년 7 월까지 의정부성모병원에 입원했던 관상동맥환자(급성심근경색증 포함) 44명(남：여＝2：22, 평균연령：63±12세)과 정상 대조군 31명(남：여＝13：18, 평균연령：43±15세)을 대상으로 하였다. 내원 후 경흉부 심장초음파(HP Sonos 1500) 기계의 2.5 MHz 위상의 탐촉자를 사용하여 심첨 4방도에서 색 M형 도플러 심초음파도를 이용하여 좌심실 유입혈류의 Vp(propagation velocity)를 측정하여 좌심실 이완기 기능을 평가했고 기존의 좌심실 이완기 기능평가지표를 구하여 비교하였다. 결 과： 1) 관상동맥질환 환자군에서 Vp값이 32.8±9.1 cm/sec로 정상대조군의 63.6±14.1cm/sec 보다 낮았고(p<0.01), 관상동맥질환 환자군중에서 좌심실 비대가 있는군(30.1±8.6 cm/sec)이 없는군(35.9±8.9 cm/sec)에 비해 통계적으로 유의하게 낮았다(p<0.01). 2) Vp는 경흉부 심장초음파로 구한 좌심실 구혈률과 유의한 상관관계를 보였고(r＝0.602, p<0.01) 좌심실 질량과는 역상관관계를 보였다(r＝-0.576, p<0.01).이외에 폐정맥 혈류의 D파와 유의한 상관관계가 있었고(r＝0.517, p<0.01) 좌심실 유입혈류의 E/A비와 상관관계가 있었다(r＝0.540, p<0.01). 결 론： 경흉부 심초음파의 색 M형 도플러 심초음파도를 이용한 Vp의 측정은 급성 심근 경색증을 포함한 관상동맥질환 환자에서 좌심실 이완기 기능평가의 유용한 방법으로 사용될 수 있을 것으로 사료된다.

Purpose：The aims of this study were to evaluate the usefulness of the propagation velocity (Vp) measured by transthoracic color M-mode Doppler in patients with coronary artery disease and compare Vp with conventional diastolic function index using transmitral and pulmonary vein flow. Methods：Study subjects were classified into two groups according to the presence of coronary artery disease (CAD)：44 subjects (M：F＝22：22, mean age 63±12 yrs) with CAD (AMI；n ＝13 , unstable angina；n＝5, stable angina；n＝26)；31 normal subjects (M：F＝13：18, mean age 43±15 yrs). Vp of early flow into left ventricular cavity measured by color M-mode Doppler was proposed as an index of left ventricular diastolic function. Vp was compared with conventional diastolic function index. Results：1.Vp in CAD patients (32.8±9.1 cm/sec) was lower than control (63.6±14.1 cm/sec) (p>0.01). Among CAD patients, Vp in CAD patients (30.1±8.6 cm/sec) with left ventricular hypertrophy (LVH) was lower than Vp in CAD patients without LVH (35.9±8.9 cm/sec) (p>0.01). 2.Vp was correlated with left ventricular ejection fraction (r＝0.602, p>0.01), with D wave of pulmonary vein flow (r＝0.540, p<0.01) and with E/A velocity ratio of mitral inflow (r＝0.517, p>0.01) and negatively correlated with left ventricular mass index (r＝-0.576, p>0.01). Conclusion：The propagation velocity measured by color M-mode Doppler is a useful index for evaluation of diastolic function of left ventricle in the patients with coronary artery disease.

Purpose：The aims of this study were to evaluate the usefulness of the propagation velocity (Vp) measured by transthoracic color M-mode Doppler in patients with coronary artery disease and compare Vp with conventional diastolic function index using transmitral and pulmonary vein flow. Methods：Study subjects were classified into two groups according to the presence of coronary artery disease (CAD)：44 subjects (M：F＝22：22, mean age 63±12 yrs) with CAD (AMI；n ＝13 , unstable angina；n＝5, stable angina；n＝26)；31 normal subjects (M：F＝13：18, mean age 43±15 yrs). Vp of early flow into left ventricular cavity measured by color M-mode Doppler was proposed as an index of left ventricular diastolic function. Vp was compared with conventional diastolic function index. Results：1.Vp in CAD patients (32.8±9.1 cm/sec) was lower than control (63.6±14.1 cm/sec) (p>0.01). Among CAD patients, Vp in CAD patients (30.1±8.6 cm/sec) with left ventricular hypertrophy (LVH) was lower than Vp in CAD patients without LVH (35.9±8.9 cm/sec) (p>0.01). 2.Vp was correlated with left ventricular ejection fraction (r＝0.602, p>0.01), with D wave of pulmonary vein flow (r＝0.540, p<0.01) and with E/A velocity ratio of mitral inflow (r＝0.517, p>0.01) and negatively correlated with left ventricular mass index (r＝-0.576, p>0.01). Conclusion：The propagation velocity measured by color M-mode Doppler is a useful index for evaluation of diastolic function of left ventricle in the patients with coronary artery disease.

Diastolic function· Color M-mode Doppler propagation velocity (Vp)· Coro-nary artery disease.