血流向量成像技术对射血分数保留的主动脉瓣狭窄患者左心室收缩功能的研究  

Study of left ventricular systolic function by vector flow mapping in patients with aortic stenosis retained in ejection fraction

作　　者：刘瑞杰 李亚南 王莹 崔存英 胡彦斌 刘琳 Liu Ruijie;Li Yanan;Wang Ying;Cui Cunying;Hu Yanbin;Liu Lin(Department of Echocardiography, People′s Hospital of Zhengzhou University, Henan Provincial People's Hospital, Fuwai Central China Cardiovascular Hospital, Zhengzhou 450003, China)

机构地区：[1]郑州大学人民医院/河南省人民医院/阜外华中心血管病医院超声科,郑州450003

出　　处：《中华超声影像学杂志》2019年第3期211-217,共7页Chinese Journal of Ultrasonography

基　　金：国家自然科学基金(81401419);河南省科技攻关(17210231003);河南省医学科技攻关计划项目(201602173,2018020452).

摘　　要：目的应用血流向量成像(VFM)技术定量评价射血分数保留的主动脉瓣狭窄患者左心室平均能量损耗的改变。方法选取健康人35例作为对照组,主动脉瓣狭窄患者71例作为病例组,其中轻度主动脉瓣狭窄(miAS)组23例,中度主动脉瓣狭窄(moAS)组23例,重度主动脉瓣狭窄(seAS)组25例。常规超声心动图测量左心房前后径(LAA)、左心室舒张末期内径(LVEDD)、左心室舒张末期容积(LVEDV)、左心室收缩末期容积(LVESV)、左心室射血分数(LVEF)、E峰/A峰(E/A)。VFM技术测量各组左心室等容收缩期及快速射血期平均整体能量损耗(EL-T)、基底段能量损耗(EL-B)、中间段能量损耗(EL-M)及心尖段能量损耗(EL-A),比较各组间平均能量损耗的差异。结果与对照组比较,各病例组等容收缩期及快速射血期平均EL-B、EL-M及EL-T均增大,seAS组等容收缩期平均EL-A增大,差异有统计学意义(均P<0.05);与miAS组相比,seAS组等容收缩期及快速射血期平均EL-B、EL-M及EL-T均增大,moAS组、seAS组快速射血期平均EL-A增大,差异有统计学意义(均P<0.05)。结论VFM技术能够反映射血分数保留的主动脉瓣狭窄患者左心室心腔内的血流动力学改变,为评价主动脉瓣狭窄患者左心室收缩功能提供了一种新方法。Objective To quantitatively analyze the changes in left ventricular mean energy loss (EL) using blood flow vector imaging (VFM) in patients with aortic stenosis retained by ejection fraction. Methods Thirty-five subjects were selected as the control group, and 71 patients with aortic stenosis were chosen as the case group, including mild aortic stenosis (miAS) group(23 cases), moderate aortic stenosis (moAS) group(23 cases), and severe arterial stenosis (seAS) group(25 cases). Left atrial anteroposterior diameter (LAA), left ventricular end-diastolic diameter (LVEDD), left ventricular end-diastolic volume (LVEDV), left ventricular end-systolic volume (LVESV), left ventricular ejection fraction (LVEF) and E/A were measured by conventional echocardiography. The average total EL (EL-T), average basal segment EL (EL-B), average middle segment EL (EL-M) and average apical segment EL (EL-A) of each isovolumic contraction phase (IVC) and rapid ejection phase (RE) were measured by VFM, and the differences in mean EL among each groups were compared. Results Compared with those in the control group, average EL-B, average EL-M and average EL-T in each case group of the left ventricle during IVC and RE were increased, the average EL-A in seAS group of the left ventricle during IVC were increased, and the differences were statistically significant(all P<0.05). Compared with those in miAS group, the average EL-B, average EL-M and average EL-T in seAS group of the left ventricle during IVC and RE were increased, and the differences were statistically significant(all P<0.05). Compared with those in miAS group, the average EL-A in moAS group and seAS group of the left ventricle during RE were increased, and the differences were statistically significant(all P<0.05). Conclusions VFM technology can directly reflect the hemodynamic changes in the left ventricular chamber of patients with aortic stenosis retained by ejection fraction, and provide a new method for the evaluation of left ventricular systolic function in patients with a

关 键 词：超声心动描记术 主动脉瓣狭窄 射血分数保留 血流向量成像技术 能量损耗 心室功能 左 

分 类 号：R542.5[医药卫生—心血管疾病] R540.45[医药卫生—内科学]