血流向量图分析左心室射血初速度与舒张晚期涡流的关系  

Assessment of relationship between preejectional flow velocity and late diastolic vortex in left ventricular chamber by vector flow mapping

作　　者：李熠玮 张海滨 韩瑜 吴玲 张晓霞 李巧贞 吴小艺 车昕怡 黎志国 LI Yi-wei;ZHANG Hai-bin;HAN Yu;WU Ling;ZHANG Xiao-xia;LI Qiao-zhen;WU Xiao-yi;CHEXin-yi;LI Zhi-guo(Graduate School of Dalian Medical University,Dalian 116044,Liaoning,China;Department of Ultrasound,PLA 967 Hospital,Dalian 116021,Liaoning China;Graduate School of Jinzhou Medical University,Jinzhou 121001,Liaoning,China)

机构地区：[1]大连医科大学研究生院,辽宁大连116044 [2]中国人民解放军第967医院特诊科,辽宁大连116021 [3]锦州医科大学研究生院,辽宁锦州121001

出　　处：《心脏杂志》2019年第6期681-684,共4页Chinese Heart Journal

基　　金：大连市医学科学研究计划项目资助(1712063)

摘　　要：目的应用血流向量图技术(vector flow mapping,VFM)研究射血前期左心室流出道血流速度与舒张晚期涡流之间关系。方法对照组健康人55例,冠心病患者123例分为左心室射血分数(LVEF)>50%组和LVEF<50%组。左室长轴切面记录彩色多普勒信号,测量舒张末期前向涡流面积及流量(除以心腔面积进行校正)及流出道射血前期血流速度(V0)。结果对照组V0与涡流校正前、后流量及二尖瓣口A峰速度中度相关,校正后流量(β=0.532,P<0.01)是V0的独立影响因素(R2=0.283,P<0.01)。LVEF<50%组涡流面积、流量大于其余两组,校正后流量小于其余两组(均P<0.05),校正后涡流面积3组之间的差异无统计学意义。LVEF<50%组V0小于其余两组(均P<0.05),其余两组之间的差异无统计学意义。患者中V0与涡流校正后流量、左心室大小、LVEF、二尖瓣环收缩和舒张晚期速度s’、a’中度相关,舒张短径(β=-0.329,P<0.01)、a’(β=0.266,P=0.01)及涡流校正后流量(β=0.188,P<0.05)是V0的独立影响因素(R2=0.441,P<0.01)。结论左心室射血初速度与涡流密切相关。AIM To clarify the relationship between preejectional flow velocity in left ventricular(LV)outflow tract(V0)and vortex in LV chamber during late diastole using vector flow mapping(VFM).METHODS Color Doppler flow images were recorded from LV apical long-axis view in 55 healthy volunteers and 123 patients with coronary artery disease.The patients were divided into two groups:patients with LV ejection fraction(LVEF)>50%and patients with LVEF<50%.The area and flux of the anterior vortex in LV chamber at end-diastole and V0 were measured.RESULTS In healthy volunteers,V0 was moderately related with vortex flux,corrected flux and transmitral A velocity,respectively.Corrected flux of vortex was the only independent predictor of V0(R2=0.283,P<0.01).Area and flux of vortex in patients with LVEF<50%were greater than those in the other two groups,whereas corrected flux was lower than those in the other two groups(both P<0.05).There was no significant difference in corrected vortex area between the three groups.V0 in patients with EF<50%was lower than those in the other two groups(both P<0.05)and no significant difference in V0 was found between the other two groups.In all patients,V0 was moderately related with corrected vortex flux,LV size,EF,and systolic and late diastolic mitral annular velocities(s’and a’),respectively.LV enddiastolic short diameter(β=−0.329,P<0.01),a’(β=0.266,P<0.01)and corrected vortex flux(β=0.188,P<0.05)were the independent predictors of V0.CONCLUSION The preejectional flow velocity in LV outflow tract is closely related to the vortex occurring during late LV diastole.The momentum of transmitral flow during late diastole can be transferred to LV outflow tract by the vortex,which facilitates LV ejection.

关 键 词：超声心动描记术 涡流 左 血流向量图 彩色多普勒血流显像 

分 类 号：R541[医药卫生—心血管疾病]