中华心血管病杂志
中華心血管病雜誌
중화심혈관병잡지
Chinese Journal of Cardiology
2011年
11期
1016-1020
,共5页
冯杰莉%李昭屏%王金锐%高炜
馮傑莉%李昭屏%王金銳%高煒
풍걸리%리소병%왕금예%고위
心肌梗死%血流速度%心肌收缩%血流向量成像
心肌梗死%血流速度%心肌收縮%血流嚮量成像
심기경사%혈류속도%심기수축%혈류향량성상
Myocardial infarction%Blood flow velocity%Myocardial contraction%Vector flow mapping
目的 应用血流向量成像( VFM)技术分析前壁心肌梗死(心梗)患者左心室涡流和血流向量特点及其与收缩功能的关系.方法 前壁心梗患者(心梗组)31例,对照组20例.记录心尖三腔心彩色多普勒二维图像,VFM技术观察各心动时相左心室涡流和血流速度向量特点.结果 (1)两组在等容收缩期左心室腔内均可见整体涡流；心梗组收缩期及舒张期左心室内均存在涡流,对照组收缩期未见涡流,舒张期左室内可见短暂、局部涡流.(2)心梗组快速射血期心尖部及中部血流速度方向朝向心尖,与基底部血流方向相反,也与对照组相反[(10.6±8.3) cm/s比-(5.8±7.2)cm/s,(19.5±11.8) cm/s比-(16.6±14.7) cn/s]；快速充盈期心尖部血流速度低于对照组[(6.8±9.8) cm/s比(17.6±15.8)cm/s,P＜0.01].(3)心梗组心尖部快速射血期血流速度与左心室射血分数(LVEF)呈负相关(r= -0.52,P＜0.05).心梗组LVEF＜ 50％患者快速射血期心尖部血流速度高于LVEF≥50％患者[(13.5±9.0) cm/s比(5.8±5.1) cm/s,P＜0.01].结论 前壁心梗患者左心室内涡流持续时间较对照组延长,心梗组快速射血期心尖部及中部血流向量方向朝向心尖,心尖部血流速度与LVEF呈负相关.
目的 應用血流嚮量成像( VFM)技術分析前壁心肌梗死(心梗)患者左心室渦流和血流嚮量特點及其與收縮功能的關繫.方法 前壁心梗患者(心梗組)31例,對照組20例.記錄心尖三腔心綵色多普勒二維圖像,VFM技術觀察各心動時相左心室渦流和血流速度嚮量特點.結果 (1)兩組在等容收縮期左心室腔內均可見整體渦流；心梗組收縮期及舒張期左心室內均存在渦流,對照組收縮期未見渦流,舒張期左室內可見短暫、跼部渦流.(2)心梗組快速射血期心尖部及中部血流速度方嚮朝嚮心尖,與基底部血流方嚮相反,也與對照組相反[(10.6±8.3) cm/s比-(5.8±7.2)cm/s,(19.5±11.8) cm/s比-(16.6±14.7) cn/s]；快速充盈期心尖部血流速度低于對照組[(6.8±9.8) cm/s比(17.6±15.8)cm/s,P＜0.01].(3)心梗組心尖部快速射血期血流速度與左心室射血分數(LVEF)呈負相關(r= -0.52,P＜0.05).心梗組LVEF＜ 50％患者快速射血期心尖部血流速度高于LVEF≥50％患者[(13.5±9.0) cm/s比(5.8±5.1) cm/s,P＜0.01].結論 前壁心梗患者左心室內渦流持續時間較對照組延長,心梗組快速射血期心尖部及中部血流嚮量方嚮朝嚮心尖,心尖部血流速度與LVEF呈負相關.
목적 응용혈류향량성상( VFM)기술분석전벽심기경사(심경)환자좌심실와류화혈류향량특점급기여수축공능적관계.방법 전벽심경환자(심경조)31례,대조조20례.기록심첨삼강심채색다보륵이유도상,VFM기술관찰각심동시상좌심실와류화혈류속도향량특점.결과 (1)량조재등용수축기좌심실강내균가견정체와류；심경조수축기급서장기좌심실내균존재와류,대조조수축기미견와류,서장기좌실내가견단잠、국부와류.(2)심경조쾌속사혈기심첨부급중부혈류속도방향조향심첨,여기저부혈류방향상반,야여대조조상반[(10.6±8.3) cm/s비-(5.8±7.2)cm/s,(19.5±11.8) cm/s비-(16.6±14.7) cn/s]；쾌속충영기심첨부혈류속도저우대조조[(6.8±9.8) cm/s비(17.6±15.8)cm/s,P＜0.01].(3)심경조심첨부쾌속사혈기혈류속도여좌심실사혈분수(LVEF)정부상관(r= -0.52,P＜0.05).심경조LVEF＜ 50％환자쾌속사혈기심첨부혈류속도고우LVEF≥50％환자[(13.5±9.0) cm/s비(5.8±5.1) cm/s,P＜0.01].결론 전벽심경환자좌심실내와류지속시간교대조조연장,심경조쾌속사혈기심첨부급중부혈류향량방향조향심첨,심첨부혈류속도여LVEF정부상관.
Objective To assess left ventricular vortex and flow vector features and the relationship between vector flow and left ventricular systolic function in patients with anterior myocardial infarction by echocardiography-derived vector flow mapping (VFM).Methods Echocardiography was performed in 31patients with anterior myocardial infarction and 20 healthy controls.Flow vector and velocity of left ventricle were analyzed on apical 3 chambers view with color Doppler.Results ( 1 ) Left ventricular intracavitary vortex during isovotumic contraction phase could be detected in both groups.Vortex was detectable also during contraction phase and relaxation phase in patients with myocardial infarction.There was no vortex during contraction phase,and there was only small and transit vortex during relaxation phase in control group.(2)Flow vector of apex and middle segments directed to apex and was opposite to that of basal segment of left ventricle in patients with myocardial infarction and in controls [ ( 10.6 + 8.3 ) cm/s vs.- (5.8 ±7.2) cm/s,( 19.5 ± 11.8) cm/s vs.- ( 16.6 ± 14.7) cm/s].During rapid relaxation phase,the velocity in apex was lower in patients with myocardial infarction than that in control group [ (6.8 ±9.8)cm/s vs.( 17.6 ± 15.8) cm/s,P ＜0.O1 ].(3)There was a negative correlation between velocity in apex and left ventricular ejection fraction (LVEF) during rapid eject phase in patients with anterior myocardial infarction (r = - 0.52,P ＜ 0.05 ).Velocity in apex of patients with LVEF ＜ 50％ was higher than that of patients with LVEF≥50％ during rapid eject phase [(13.5 ±9.0) cm/s vs.(5.8 ±5.1) cm/s,P ＜0.05 ].Conclusions Vortex period is prolonged in patients with anterior myocardial infarction compared to normal controls during whole cardiac cycle,flow vector of apex and middle segments is directed to apex during eject phase and there is a negative correlation between velocity in apex and LVEF during rapid eject phase in patients with anterior myocardial infarction.
