Evaluation of hemodynamics in patients with hypertrophic cardiomyopathy by vector flow mapping: Comparison with healthy subjects
Evaluation of hemodynamics in patients with hypertrophic cardiomyopathy by vector flow mapping: Comparison with healthy subjects
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矢量流图评估肥厚型心肌病患者的血流动力学：与健康受试者的比较
DOI：
10.3892/etm.2019.7507
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发表时间：
2019-06-01
影响因子：
2.7
通讯作者：
Shang, Yuan-Yuan
中科院分区：
文献类型：
--
作者：
Cao, Yuan;Sun, Xiao-Yan;Shang, Yuan-Yuan
本研究探讨了肥厚型心肌病（HCM）患者的向量流图（VFM）评估的能量损失的作用。对42例HCM患者和40例对照组进行VFM分析，这些患者的年龄、性别和左心室（LV）射血分数相匹配。在心尖三腔心切面上测量左心室和左心房内血流，计算收缩期和舒张期能量损失（EL）。测量结果在三个心动周期内取平均值，并以体表面积为索引。与对照组相比，肥厚型心肌病患者左室舒张期能量损失（LVEL）总量显著降低（P1、P2、P3，均P<0.05）。肥厚型心肌病患者的LVEL总收缩期值较对照组有增高趋势（P>0.05）。HCM患者在P1和P2（缓慢充盈时间）期间LVEL基础值降低。与对照组相比，肥厚型心肌病患者舒张期LVEL中值降低（P0、P1、P2和P3;均P<0.05）。HCM组LVEL中值在收缩期P5时明显高于对照组（P<0.05）。HCM患者在P0、P2和P3时LVEL-心尖降低。与对照组相比，HCM组左房各时相能量损失（LAEL）均明显降低（均P<0.01）。HCM患者的舒张期LVEL值显著低于对照组;然而，HCM患者的收缩期LVEL水平往往较高。肥厚型心肌病患者储库期、导管期和心房收缩期的LAEL均低于对照组。本研究表明，通过VFM测量EL是确定HCM患者亚临床LV功能障碍的敏感方法。EL值已被认为是估计脑室内血流效率的定量参数。
The present study investigated the role of energy loss assessed by vector flow mapping (VFM) in patients with hypertrophic cardiomyopathy (HCM). VFM analysis was performed in 42 patients with HCM and in 40 control subjects, which were matched for age, sex and left ventricular (LV) ejection fraction. The intra-LV and left atrial blood flow were obtained from the apical 3-chamber view, and the energy loss (EL) during the systolic and diastolic phases was calculated. The measurements were averaged over three cardiac cycles and indexed to body surface area. Compared with the controls, the left ventricular energy loss (LVEL)-total value was significantly decreased in patients with HCM during the diastolic phase (P1, P2 and P3; all P<0.05). A tendency for increased systolic LVEL-total values was observed in the patients with HCM compared with the controls (P>0.05). LVEL-base values were decreased in the patients with HCM during P1 and P2 (slow filling time). Compared with the controls, patients with HCM had lower LVEL-mid values during the diastolic phases (P0, P1, P2 and P3; all P<0.05). However, the LVEL-mid value of patients with HCM was higher compared with that of the controls during systolic P5 (P<0.05). LVEL-apex was decreased in patients with HCM during P0, P2 and P3. Compared with the controls, the left atrial energy loss (LAEL) of all three phases in patients with HCM were lower (each P<0.01). The diastolic LVEL values were significantly lower in patients with HCM compared with the controls; however, the systolic LVEL levels tended to be higher in HCM. The LAEL of the reservoir phase, conduit phase and atrial systolic phase were decreased in HCM compared with controls. The present study demonstrated that measurement of EL by VFM is a sensitive method of determining subclinical LV dysfunction in patients with HCM. The value of EL has been considered to be a quantitative parameter for the estimation of the efficiency of intraventricular blood flow.