CAJ | 학술논문

目的超声观察主动脉右冠瓣与无冠瓣交界处血流加速,并结合心脏形态学及血流动力学分析其形成机制.方法 37例主动脉右冠瓣与无冠瓣交界处血流加速者为观察组,35例健康志愿者为对照组.用彩色多普勒于主动脉根部短轴切面显示收缩期主动脉瓣口血流信号;测量实验组及对照组左室腔与左室流出道中轴线的夹角;用脉冲多普勒测量主动脉瓣及左室流出道收缩期峰值流速.结果观察组的主动脉右冠瓣与无冠瓣交界处收缩期彩色血流信号显示明亮、部分呈湍流.观察组与对照组心尖五腔切面左室腔与左室流出道二者中轴线的夹角分别为128°±15°及145°±13°(P＜0.01);心尖三腔切面左室腔与左室流出道二者中轴线的夹角分别为126°±19°及141°±16°(P＜0.01).与对照组相比,观察组由左室到主动脉瓣的空间心腔轴线变化幅度增大,主要表现为前后方向的变化幅度增大.结论主动脉右冠瓣与无冠瓣交界处的血流加速与左室腔、左室流出道夹角变小所致的主动脉瓣口血流速度不均匀,并与主动脉右冠瓣与无冠瓣交界处所处的方位有关.
목적 초성관찰주동맥우관판여무관판교계처혈류가속,병결합심장형태학급혈류동역학분석기형성궤제.방법 37례주동맥우관판여무관판교계처혈류가속자위관찰조,35례건강지원자위대조조.용채색다보륵우주동맥근부단축절면현시수축기주동맥판구혈류신호;측량실험조급대조조좌실강여좌실류출도중축선적협각;용맥충다보륵측량주동맥판급좌실류출도수축기봉치류속.결과 관찰조적주동맥우관판여무관판교계처수축기채색혈류신호현시명량、부분정단류.관찰조여대조조심첨오강절면좌실강여좌실류출도이자중축선적협각분별위128°±15°급145°±13°(P＜0.01);심첨삼강절면좌실강여좌실류출도이자중축선적협각분별위126°±19°급141°±16°(P＜0.01).여대조조상비,관찰조유좌실도주동맥판적공간심강축선변화폭도증대,주요표현위전후방향적변화폭도증대.결론 주동맥우관판여무관판교계처적혈류가속여좌실강、좌실류출도협각변소소치적주동맥판구혈류속도불균균,병여주동맥우관판여무관판교계처소처적방위유관.
Objective To observe the accelerating flow of the juncture of right coronary leaflet and non-coronary leaflet (JRN)and analyze its mechanism with cardiac morphology and hemodynamics.Methods 37 subjects with accelerating flow of JRN were included in this study.35 healthy volunteers were the controls.Systolic flow of aortic valvular orifice was observed at the short axis view of the aortic root with Color Doppler flowing imaging (CDFI).The included angles between the central lines of left ventricular chamber and left ventricular outflow tract (IACL）were measured in the subjects and controls.The systolic peak flow velocities of aortic valvular orifice and left ventricular outflow tract were quantified with pulsed wave Doppler.Results The systolic flow of the JRN in subjects was bright and turbulent partly viewed with CDFI.The IACLs at apical five-chamber view in the subjects and controls were 128°±15° VS 145°±13°,respectively(P<0.01).The IACLs at apical three-chamber view in the subjects and controls were 126°±19° VS 141°±16°,respectively(P<0.01).The central line of the cavity from left ventricular chamber to aortic valve changed more significantly in the subjects than that in the controls,and the change was mainly in the anterior-posterior direction of the central line.Conclusions The accelerating flow of JRN was related to the nonuniform flow of aortic valvular orifice caused by the small IACL and the position of JRN.