血流向量成像技术评价前壁心肌梗死患者左心室能量损耗  

Left ventricular energy loss assessed by vector flow mapping in patients with anterior wall myocardial in⁃farction

作　　者：谢姝瑞 马小静 夏娟[2] XIE Shu-rui;MA Xiao-jing;XIA Juan(School of Medicine,Wuhan University of Science and Technology,Wuhan 430065,China;Department of Ultrasound,Wuhan Asian Heart Hospital,Wuhan 430022,China)

机构地区：[1]武汉科技大学医学院,武汉430065 [2]武汉科技大学附属武汉亚洲心脏病医院超声科,武汉430022

出　　处：《岭南心血管病杂志》2020年第6期635-639,659,共6页South China Journal of Cardiovascular Diseases

基　　金：武汉市科技局项目(项目编号:2019020701011422)。

摘　　要：目的应用超声血流向量成像(vector flow mapping,VFM)技术可视量化评价前壁心肌梗死患者不同时相、各节段左心室血流的能量损耗(energy loss,EL)变化,探讨其在评价左心室功能中的临床价值。方法选择2018年10月至2019年2月在武汉科技大学医学院就诊的42例前壁心肌梗死患者为病例组,并根据有无心尖段室壁瘤,将病例组分为无室壁瘤组(A组,n=22)、合并室壁瘤组(B组,n=20);同时选取同期就诊的32例正常体检者为健康对照组(N组)。采用VFM技术对各组不同时相、各节段的左心室能量损耗进行测定和比较。结果 (1)不同时相各节段EL比较:与N组比较,B组于等容收缩期(isovolumetric contraction,IVC)心尖段EL增高,前壁心肌梗死(A组、B组)患者于快速射血期(rapid ejection,RE)心尖段、中间段EL均增高,于快速充盈期(rapid filling,RF)各节段EL均减低,于心房收缩期(atrial contraction,AC)基底段EL增高,差异均具有统计学意义(P<0.05)。(2)不同时相整体EL比较:与N组相比,A组、B组均在RE、AC总体EL增高,在RF总体EL减低,差异具有统计学意义(P<0.05)。结论前壁心肌梗死患者室壁运动不协调影响心腔内血流动力学变化,从而使心腔内能量损耗发生变化,能量损耗为评估心功能提供新途径。Objectives To detect the dynamic changes of energy loss(EL)in patients with anterior myocardial infarction during the each phase of cardiac cycle and different section by vector flow mapping(VFM)technology,and to explore its clinical value in evaluating left ventricular function.Methods During October 2018 to February 2019,22 patients with extensive anterior myocardial infarction without ventricular aneurysm were chosen as A group;20 patients with extensive anterior myocardial infarction complicated with ventricular aneurysm were chosen as B group;32 healthy participants were enrolled as N group.The energy loss of left ventricular at five phases and different sections were analyzed by VFM.Results(1)For EL in different phases and sections:compared with N group,the apex EL of B group was higher in isovolumetric contraction(IVC),the apex and middle EL of A and B group was higher in rapid ejection(RE)period,the EL in all sections of A and B group was lower in rapid filling(RF)period,the basic EL is higher in atrial contraction(AC)(P<0.05).(2)Compared with group N,the whole EL of the group A and B is higher in RE period and AC,and lower RF period(P<0.05).Conclusions In patients with anterior wall myocardial infarction,uncoordinated wall motion affects emodynamics and changes the energy loss in the cardiac cavity.Energy loss serves as a new approach to estimate cardiac function.

关 键 词：前壁心肌梗死 血流向量成像 能量损耗 

分 类 号：R542.22[医药卫生—心血管疾病]