VFM技术评价急性下壁心肌梗死患者PCI前后收缩期左心室的涡流特征  

Evaluation of Vortex in Left Ventricle During Systolic Phase in Patients with Acute Myocardial Infarction by Vector Flow Mapping before and after PCI

作　　者：刘蕊 纳丽莎[2] 刘丽文[3] 马斌[3] 周丽[2] 郭建英[3] 

机构地区：[1]鹤壁市鹤煤集团总医院超声科,河南省鹤壁市458000 [2]宁夏医科大学附属医院功能检查科 [3]解放军第四军医大学西京医院超声诊断科

出　　处：《中国超声医学杂志》2012年第9期813-816,共4页Chinese Journal of Ultrasound in Medicine

基　　金：陕西省社发攻关计划项目(No.2010K15-01-01)

摘　　要：目的应用血流向量成像(VFM)技术评价急性下壁心肌梗死患者经皮冠状动脉介入术(PCI)术前、术后1个月左心室内血流动力学的变化特征。方法 40例正常人和25例急性下壁心肌梗死患者PCI前、后行超声心动图检查,采集标准心尖三腔心切面连续3个心动周期的彩色血流动态图像。VFM涡流模式脱机分析,测量收缩期左室内涡流横纵径、横向位置、纵向位置,涡流的最大向量速度、流量、涡强度,比较急性下壁梗死患者与正常人及其PCI术后上述各参数的差异。结果与正常人比较,急性下壁心肌梗死患者的等容收缩期、收缩早期左室涡流纵径增大(P<0.05),横向位置靠近后侧壁,涡流最大向量速度、流量、涡强度下降(P均<0.05);急性下壁心肌梗死患者于PCI术后1个月涡流纵径小于术前(P<0.05),横向位置靠近前间隔侧,涡流最大向量速度、流量、涡强度较术前增加(P均<0.05)。结论急性下壁心肌梗死患者收缩期左心室涡流变化有其一定特征,PCI术后涡流相关参数较术前有改善,VFM可作为评价急性下壁心肌梗死患者及其PCI术治疗前后心腔内血液流场变化提供了一个新方法 。Objective To research characteristic of vortex in left ventricle （LV） patients with acute inferior myo-cardial infarction before and after PCI by vector flow mapping （VFM）. Methods Forty normal persons and twenty-five patients with acute inferior myocardial infarction were examined by two-dimensional echocardiography before and after PCI. The apical three-chamber Color Doppler images in three sequent cardiac cycles were acquired and analyzed off-line with VFM. The vortex parameters of LV including longitudinal length, horizontal length, transverse position, vertical position, maximum vector speed, vortex flow, strength of vortex were measured. The differences were com- pared between patients with acute inferior myocardial infarction before and after PCI. Results In the same volume and early systolic stage, longitudinal diameter was longer in patients with acute inferior myocardial infarction than that of normal persons （P〈0.05）, transverse position was closer to inferior infarction of heat, vortex maximum speed, vor-tex flow, strength of vortex were reduced （P〈0.05） ; Longitudinal diameter was shorter after PCI （P〈0.05）, trans-verse position was closer to former ventricular apical of heat , vortex maximum, vortex flow, strength of vortex were increased （P〈0.05）. Conclusions The vortex changes in patients with acute inferior myocardial infarction exist a cer-tain characteristic, mate hemodynamic the parameters of vortex were ameliorated after PCI. VFM may serve as a new approach to esti of heart before and after PCI.

关 键 词：超声心动图描记术 血流向量成像技术 急性下壁心肌梗死 经皮冠状动脉介入术 涡流 

分 类 号：R542.22[医药卫生—心血管疾病]