血流向量成像技术评价肥厚型心肌病患者左心室舒张期流体力学变化  

Evaluating Changes of Left Ventricular Diastolic Fluid by Vector Flow Mapping in Patients with Hypertrophic Cardiomyopathy

作　　者：王伟[1] 白晖[1] 周金玲[1] 高泽 常青 王岳恒[1] Wang Wei;Bai Hui;Zhou Jinling;Gao Ze;Chang Qing;Wang Yueheng(Department of Cardiac Ultrasound,The Second Hospital of Hebei Medical University,Shijiazhuang 050000,China)

机构地区：[1]河北医科大学第二医院心脏超声科,石家庄市050000

出　　处：《中国超声医学杂志》2023年第1期30-34,共5页Chinese Journal of Ultrasound in Medicine

摘　　要：目的 应用血流向量成像(VFM)技术分析肥厚型心肌病(HCM)患者舒张期血流流场改变及影响因素。方法 选取HCM 33例,对照组33例,计算等容舒张期、充盈早期、充盈期平均能量损耗,即IVR-EL-ave、E-EL-ave、A-EL-ave;充盈早期及左房充盈期循环强度E-cir、A-cir,涡旋面积E-vor-area、A-vor-area,比较两组各参数差异,分析E-EL-ave、A-EL-ave独立影响因素。结果 (1)与对照组比较,HCM组E-EL-ave、E-vor-area、A-vor-area降低,A-EL-ave增加(P<0.05)。(2)HCM组11例(33%)患者出现“E-filling涡流环缺失”现象,与存在涡流环HCM患者相比,其A-EL-ave增加,LVEDVI减小(P<0.05)。(3)HCM组E-EL-ave与LVEDVI、E峰速率有独立相关性;A-EL-ave与A峰速率及A-cir有独立相关性。结论 VFM相关参数可以反映HCM舒张期异常血流动力学情况,左室充盈期能量损耗变化与非生理性涡流及左室容积有关。Objective To investigate the changes of diastolic blood flow field and related influencing factors in patients with hypertrophic cardiomyopathy(HCM) by vector flow mapping(VFM).Methods 33 patients with HCM and 33 healthy controls were selected.VFM analysis was performed to calculate the average energy loss during isovolumic relaxation phase(IVR-EL-ave),early filling phase(E-EL-ave),atrial filling phase(A-EL-ave).The circulation and vortex area of early filling phase(E-cir),(E-vor-area) and atrial filling phase(A-cir),(A-vor-area) were calculated,the differences of various parameters between the two groups were compared.The independent factors associated with E-EL-ave and A-EL-ave were analyzed.Results(1) Compared to the control group,the E-EL-ave,E-vor-area,A-vor-area of the HCM group was weaker and A-EL-ave was increased(P<0.05).(2) The “absent E-peak vortex ring” phenomenon was observed in 11 patients(33%) of the HCM group,which had significantly increased A-EL-ave and relatively reduced left ventricle end-diastolic volume index(LVEDVI)(P<0.05).(3) The E-EL-ave was independently associated with LVEDVI,E peak,and A-EL-ave were independently correlated with A-peak,and A-cir in the HCM group.Conclusions Abnormal diastolic hemodynamics in HCM can be detected by VFM related parameters.The change of energy loss during left ventricular filling is related to intraventricular non-physiological vortex and left ventricular volume.

关 键 词：肥厚型心肌病 涡旋 能量损耗 左室容积 

分 类 号：R445.1[医药卫生—影像医学与核医学] R542.2[医药卫生—诊断学]