Left ventricular vortex formation is unaffected by diastolic impairment.
Left ventricular vortex formation is unaffected by diastolic impairment.
复制标题
左心室涡形成不受舒张期损伤的影响。
DOI：
10.1152/ajpheart.00093.2012
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发表时间：
2012
期刊：
影响因子：
--
通讯作者：
Vlachos,PavlosP
中科院分区：
文献类型：
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作者：
Stewart,KelleyC;Charonko,JohnC;Niebel,CasandraL;Little,WilliamC;Vlachos,PavlosP
正常的左心室（LV）充盈在心室内的渐进性压力梯度和低左心房压引起的舒张早期迅速发生。这种正常的舒张功能在心力衰竭患者中发生改变。舒张期充盈的这种损害表现为早期充盈波速度的突然减速。虽然早期填充波内的变化已经观察到以前，基本的流体动力学机制还没有很好地理解。以前，有人提出二尖瓣环涡环形成时间是舒张早期充盈的总持续时间，并提供了舒张充盈效率的测量。然而，我们发现，有利的左心室压力差驱动舒张早期充盈变为零，同时减速的早期充盈波传播速度和夹断的左心室涡环。因此，我们使用舒张早期充盈波从其开始到夹断发生时早期充盈波传播速度减速的持续时间计算涡环形成时间。该形成时间不随心室内压差的降低或舒张功能障碍的程度而变化。因此，我们认为涡环夹断发生在舒张早期完成之前，其形成时间与舒张功能的变化保持不变。
Normal left ventricular (LV) filling occurs rapidly early in diastole caused by a progressive pressure gradient within the ventricle and with a low left atrial pressure. This normal diastolic function is altered in patients with heart failure. Such impairment of diastolic filling is manifested as an abrupt deceleration of the early filling wave velocity. Although variations within the early filling wave have been observed previously, the underlying hydrodynamic mechanisms are not well understood. Previously, it was proposed that the mitral annulus vortex ring formation time was the total duration of early diastolic filling and provided a measure of the efficiency of diastolic filling. However, we found that the favorable LV pressure difference driving early diastolic filling becomes zero simultaneously with the deceleration of the early filling wave propagation velocity and pinch-off of the LV vortex ring. Thus we calculated the vortex ring formation time using the duration of the early diastolic filling wave from its initiation to the time of the early filling wave propagation velocity deceleration when pinch-off occurs. This formation time does not vary with decreasing intraventricular pressure difference or with degree of diastolic dysfunction. Thus we conclude the vortex ring pinch-off occurs before the completion of early diastole, and its formation time remains invariant to changes of diastolic function.