Quantification of left and right atrial kinetic energy using four-dimensional intracardiac magnetic resonance imaging flow measurements
Quantification of left and right atrial kinetic energy using four-dimensional intracardiac magnetic resonance imaging flow measurements
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DOI：
10.1152/japplphysiol.00932.2012
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发表时间：
2013-05-01
影响因子：
3.3
通讯作者：
Arheden, Hakan
中科院分区：
文献类型：
--
作者：
Arvidsson, Per M.;Toger, Johannes;Arheden, Hakan
心房血液的动能（KE）被认为是心室充盈的可能因素。因此，我们旨在利用心脏磁共振（CMR）量化左（LA）和右（RA）心房血KE。15名健康志愿者在3t时接受了CMR，包括一个四维相对比流序列。平均LA KE低于RA KE （1.1 +/- 0.1 mJ vs. 1.7 +/- 0.1 mJ, P < 0.01）。两个心房出现三个KE峰值：一个在心室收缩期，一个在心室早期舒张期，一个在心房收缩期。收缩期LA峰值明显小于RA峰值（P < 0.001），舒张期早期LA峰值明显大于RA峰值（P < 0.05）。旋转流动占总能量的46 +/- 7%，比非旋转流动更能保存能量。LA组早期舒张期KE升高幅度更大（P < 0.001）。收缩期KE与心房容积和房室平面位移收缩期速度的结合相关(LA r（2) = 0.57, RA r(2) = 0.64）。左心舒张早期KE与左心室（LV）质量相关（r(2) = 0.28），而右心无相关。这表明LA KE在心室舒张早期由于左室弹性反冲而增加，表明左室充盈依赖于舒张吸引。右心室（RV）舒张似乎与心房KE无关。相反，在心室收缩期间产生的RA KE可能在液压“飞轮”中保存，并通过螺旋流转移到右心室，这可能有助于右心室充盈。
Kinetic energy (KE) of atrial blood has been postulated as a possible contributor to ventricular filling. Therefore, we aimed to quantify the left (LA) and right (RA) atrial blood KE using cardiac magnetic resonance (CMR). Fifteen healthy volunteers underwent CMR at 3 T, including a four-dimensional phase-contrast flow sequence. Mean LA KE was lower than RA KE (1.1 +/- 0.1 vs. 1.7 +/- 0.1 mJ, P < 0.01). Three KE peaks were seen in both atria: one in ventricular systole, one during early ventricular diastole, and one during atrial contraction. The systolic LA peak was significantly smaller than the RA peak (P < 0.001), and the early diastolic LA peak was larger than the RA peak (P < 0.05). Rotational flow contained 46 +/- 7% of total KE and conserved energy better than nonrotational flow did. The KE increase in early diastole was higher in the LA (P < 0.001). Systolic KE correlated with the combination of atrial volume and systolic velocity of the atrioventricular plane displacement (r(2) = 0.57 for LA and r(2) = 0.64 for RA). Early diastolic KE of the LA correlated with left ventricle (LV) mass (r(2) = 0.28), however, no such correlation was found in the right heart. This suggests that LA KE increases during early ventricular diastole due to LV elastic recoil, indicating that LV filling is dependent on diastolic suction. Right ventricle (RV) relaxation does not seem to contribute to atrial KE. Instead, RA KE generated during ventricular systole may be conserved in a hydraulic "flywheel" and transferred to the RV through helical flow, which may contribute to RV filling.