Left ventricular flow patterns in healthy subjects and patients with prosthetic mitral valves: An in vivo study using echocardiographic particle image velocimetry
Left ventricular flow patterns in healthy subjects and patients with prosthetic mitral valves: An in vivo study using echocardiographic particle image velocimetry
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DOI：
10.1016/j.jtcvs.2009.07.060
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发表时间：
2010-06-01
影响因子：
6
通讯作者：
Voigt, Jens-Uwe
中科院分区：
文献类型：
--
作者：
Faludi, Reka;Szulik, Mariola;Voigt, Jens-Uwe
目的：超声心动图粒子图像测速技术是一种基于特征跟踪的新的在体左心室血流可视化和定量方法。我们研究了这种新技术的潜在作用，通过评估涡流形成在健康的左心室和不同类型的人工瓣膜对室内流动模式和流量介导的能量dissipation.Methods的影响：我们检查了19例（平均年龄，57 +/- 19岁; 10名妇女）。9例健康，10例植入人工二尖瓣（5例植入双叶瓣膜，4例植入生物瓣膜，1例植入倾斜盘瓣膜）。静脉注射左心造影剂。超声心动图心尖视图进行了离线分析，通过使用原型软件，允许腔内流动进行探索，并启用计算能量耗散（相对脉动涡强度和涡流脉动相关性）通过粒子图像velocimetry.Results：在健康的心脏涡流填充整个心室存储的血液的动能，并顺利重定向到流出道的血液。在人工瓣膜患者中，根据瓣膜的类型、方向和位置以及左心室几何形状，确定了完全不同的血流模式。人工瓣膜患者的左心室能量耗散明显高于健康受试者（相对脉动涡强度，2.4 +/- 0.7 vs 1.6 +/- 0.4 [P < .001];涡脉动相关性，1.2 +/- 0.5 vs 0.7 +/- 0.2 [P < .001]）。它清楚地区分了健康心脏的血流模式和不同类型人工瓣膜的心脏的血流模式。超声心动图粒子图像测速提供了新的见解，心脏功能，并可能是重要的，以优化瓣膜置换治疗。（《胸血管外科杂志》2010;139：1501-10）
Objective: Echocardiographic particle image velocimetry is a new feature tracking-based approach to visualize and quantify left ventricular flow patterns in vivo. We investigated the potential role of this new technique by assessing vortex formations in healthy left ventricles and the effect of different types of prosthetic valves on intraventricular flow patterns and flow-mediated energy dissipation.Methods: We examined 19 patients (mean age, 57 +/- 19 years; 10 women). Nine were healthy, and 10 had prosthetic mitral valves (5 had bileaflet valves, 4 had bioprostheses, and 1 had a tilting-disc valve). Boluses of left heart contrast were administered intravenously. Echocardiographic apical views were analyzed offline by using prototype software that allowed intracavitary flow to be explored and enabled calculations of energy dissipation (relative pulsatile vorticity strength and vortex pulsation correlation) by means of particle image velocimetry.Results: In healthy hearts a vortex filling the entire ventricle stores the kinetic energy of the blood and smoothly redirects the blood to the outflow tract. In patients with prosthetic valves, completely different flow patterns were identified depending on the type, orientation, and position of the valves, as well as left ventricular geometry. Patients with prosthetic valves showed significantly higher left ventricular energy dissipation than healthy subjects (relative pulsatile vorticity strength, 2.4 +/- 0.7 vs 1.6 +/- 0.4 [P < .001]; vortex pulsation correlation, 1.2 +/- 0.5 vs 0.7 +/- 0.2 [P < .001]).Conclusions: Echocardiographic particle image velocimetry is feasible. It clearly distinguishes flow patterns in healthy hearts from those in hearts with different types of prosthetic valves. Echocardiographic particle image velocimetry offers new insights into cardiac function and might be of importance to optimize valve replacement therapy. (J Thorac Cardiovasc Surg 2010;139:1501-10)