배 경： 허혈성심질환의 좌심실 이완기능을 평가하는 방법으로 심도자법과 도플러 심초음파 검사가 일반적으로 사용되고 있으나 임상적인 제한점이 적지 않다. 본 연구에서는 급성 관동맥 증후군 환자의 이완기능 장애를 확인하는 방법으로 Color M-mode 도플러 심초음파의 임상 적용 가능성에 대해 알아보고자 하였다. 방 법： 급성 관동맥 증후군으로 본원을 방문한 환자 가운데 간헐파형 도플러검사상 승모판 혈류검사와 폐정맥 혈류검사가 가능했던 59명의 환자를 대상으로 내원 24시간 내에 ATL HDI-3000을 이용한 도플러 심초음파 검사를 시행하고 정상군(Normal：E/A>1, S/D>1,DT>140 ms), 이완기 장애군(Impaired relaxation：E/A<1, DT>140 ms), 가정상 혹은 제한성 장애군(Pseudonormal or Restrictive：E/A>1.5, S/D<1, with or without DT≤140 ms)으로 분류하였다. 각 군의 간헐파형 도플러 심초음파상의 지표들과 Color Mmode 도플러 심초음파상의 ROP(rate of propagation)값과의 관계를 알아보았다. 결 과： 간헐파형 도플러 심초음파 검사상 정상군은 22명,이완기 장애군은 34명, 가정상 혹은 제한성 장애군은 3명이었다. Color M-mode도플러 심초음파도를 이용한 ROP의 측정에서는 front wave method로는 50례 (84.7%)에서 측정이 가능하였으나 baseline shift method는 19례(32.3%)에서만 측정이 가능하였다. Front wave method로 측정한 ROP의 값도 정상군과 이완기 장애군 간에 통계적으로 유의한 차이를 보이지 않았다. 결 론： 대부분의 환자에서 front wave method를 이용한 ROP의 측정은 가능하였으나 급성 관동맥 증후군 환자의 좌심실 이완기능을 반영하는 단독지표로는 적합하지 않을 것으로 생각되며 baseline shift method를 이용한 ROP의 측정은 급성 관동맥 증후군 환자에서 유용하지 못한 것으로 생각된다.

Background：Color M-mode doppler echocardiography has been suggested as a new noninvasive technique for assessing left ventricular diastolic function. The present study was performed to define the feasibility and value of color M-mode echocardiography for the assessment of left ventricular diastolic function in patients with acute coronary syndrome. Methods：Thirty six patients with acute myocardial infarcion and twenty three patients with unstable angina were included (M/F=41/18, 61±12.2 years). Doppler study was performed using ATL HDI-3000 within 24 hours after the attack. In color M-mode study, ROP was measured with ‘Front wave method’ and ‘Baseline shift method’. The patients were grouped into three groups based on E/A ratio and deceleration time (DT) in transmitral flow and S/D ratio in pulmonary venous flow；Group I = Normal pattern (E/A>1, S/D>1, DT>140 ms), Group II =Impaired relaxation pattern (E/A<1, DT>140 ms) and Group III =Pseudonormal/Restrictive pattern (E/A>1.5, S/D<1, with or without DT≤140 ms). Result：Twenty two, thirty four, and three patients were assigned to Group I, II, III, respectively. The ROP could be measured with ‘Front wave method’ in 50 patients (84.7%), but with ‘Baseline shift method’ only in 19 patients (32.2%). ROP with ‘Front wave method’ was 65±25.7, 61±35.6, 71±35.2 cm/sec in Group I, II, III, respectively. There was no statistically significant difference in the value of ROP between group I and II (p>0.05). Conclusion：The ROP seems not to reflect the diastolic function in acute coronary syndrome,although it is measurable with the ‘Front wave method’ in most cases. The measurement of the ROP with‘Baseline shift method’is not feasible in the patients with acute coronary syndrome.

Background：Color M-mode doppler echocardiography has been suggested as a new noninvasive technique for assessing left ventricular diastolic function. The present study was performed to define the feasibility and value of color M-mode echocardiography for the assessment of left ventricular diastolic function in patients with acute coronary syndrome. Methods：Thirty six patients with acute myocardial infarcion and twenty three patients with unstable angina were included (M/F=41/18, 61±12.2 years). Doppler study was performed using ATL HDI-3000 within 24 hours after the attack. In color M-mode study, ROP was measured with ‘Front wave method’ and ‘Baseline shift method’. The patients were grouped into three groups based on E/A ratio and deceleration time (DT) in transmitral flow and S/D ratio in pulmonary venous flow；Group I = Normal pattern (E/A>1, S/D>1, DT>140 ms), Group II =Impaired relaxation pattern (E/A<1, DT>140 ms) and Group III =Pseudonormal/Restrictive pattern (E/A>1.5, S/D<1, with or without DT≤140 ms). Result：Twenty two, thirty four, and three patients were assigned to Group I, II, III, respectively. The ROP could be measured with ‘Front wave method’ in 50 patients (84.7%), but with ‘Baseline shift method’ only in 19 patients (32.2%). ROP with ‘Front wave method’ was 65±25.7, 61±35.6, 71±35.2 cm/sec in Group I, II, III, respectively. There was no statistically significant difference in the value of ROP between group I and II (p>0.05). Conclusion：The ROP seems not to reflect the diastolic function in acute coronary syndrome,although it is measurable with the ‘Front wave method’ in most cases. The measurement of the ROP with‘Baseline shift method’is not feasible in the patients with acute coronary syndrome.

Diastolic function·Color M-mode doppler echocardiography·Acute coronary syndrome.