CAJ | 학술논문

目的应用超声血流向量成像(VFM)技术探讨心腔内血流的结构变化及其与左室功能之间的关系.方法选取扩张型心肌病患者26例、正常对照44例为观察对象,利用VFM软件采集左室内血流向量图像,应用VFM分析软件DSA-RS1测量收缩期心尖部-主动脉瓣口速度阶差(△Vs)、心尖部-主动脉瓣口距离(Ds)、半距对应速度(Vs1/2);舒张期二尖瓣口-心尖部速度阶差(△Vd)、二尖瓣口-心尖部距离(Dd)、半距对应速度(Vd1/2).结果与对照组相比,DCM组收缩期△Vs、Vs1/2与舒张期△Vd、Vd1/2明显降低,收缩期Ds与舒张期Dd明显延长,差异均具有统计学意义(P＜0.05).Ds、Dd与舒张末期容积、收缩末期容积、左室内径呈正相关(r＞0.4,P＜0.01),与收缩功能呈负相关(r＞0.3,P＜0.01);Vs1/2、Vd1/2与舒张末期容积、收缩末期容积、左室内径呈负相关(r＞0.3,P＜0.01),与收缩功能呈正相关(r＞0.3,P＜0.01).结论扩张型心肌病患者心腔内血流速度明显低于正常人,VFM是一种无创评价扩张型心肌病左室内血流动力学变化的新方法.
목적 응용초성혈류향량성상(VFM)기술탐토심강내혈류적결구변화급기여좌실공능지간적관계.방법 선취확장형심기병환자26례、정상대조44례위관찰대상,이용VFM연건채집좌실내혈류향량도상,응용VFM분석연건DSA-RS1측량수축기심첨부-주동맥판구속도계차(△Vs)、심첨부-주동맥판구거리(Ds)、반거대응속도(Vs1/2);서장기이첨판구-심첨부속도계차(△Vd)、이첨판구-심첨부거리(Dd)、반거대응속도(Vd1/2).결과 여대조조상비,DCM조수축기△Vs、Vs1/2여서장기△Vd、Vd1/2명현강저,수축기Ds여서장기Dd명현연장,차이균구유통계학의의(P＜0.05).Ds、Dd여서장말기용적、수축말기용적、좌실내경정정상관(r＞0.4,P＜0.01),여수축공능정부상관(r＞0.3,P＜0.01);Vs1/2、Vd1/2여서장말기용적、수축말기용적、좌실내경정부상관(r＞0.3,P＜0.01),여수축공능정정상관(r＞0.3,P＜0.01).결론 확장형심기병환자심강내혈류속도명현저우정상인,VFM시일충무창평개확장형심기병좌실내혈류동역학변화적신방법.
Objective To evaluate left ventricular function in the way of intracavitary flow dynamics by vector flow mapping (VFM) with echocardiography, and to discuss its clinical usefulness. Methods Twenty-six patients with dilated cardiomyopathy(DCM) and 44 healthy controls were involved. The velocity distribution imagings on the section plane of the flow in the left ventricle were obtained by VFM,and series parameters of velocity and distance were measured with DSA-RS1 software,including systolic parameters,such as velocity gradient from cardiac apex to the aortic valve(△Vs) ,distance from cardiac apex to the aortic valve(Ds), velocity according to half distance (Vs1/2), and diastolic parameters, such as velocity gradient from the mitral orifice to the apex(△Vd), distance from mitral orifice to cardiac apex(Dd),velocity according to half distance(Vd1/2). Results Compared with the values in the control group, parameters of systolic velocity(△Vs, Vs1/2 ) and parameters of diastolic velocity ( △Vd, Vd1/2 ) were significantly lower, parameter of systolic distance (Ds) and parameter of diastolic distance (Dd) were significantly longer( P ＜0.05). Ds,Dd were positive correlated with left ventricular(LV) end-diastolic volume(EDV), end-systolic volume (ESV) ,LV diameter ( r ＞0.4, P ＜0.01 ), and negtively correlated with LV ejection fraction(EF) ( r ＞0.3, P ＜0.01 ). Vs1/2, Vd1/2 were negtively correlated with EDV, ESV, LV diameter ( r ＞0.3, P ＜0.01 ),and positive correlated with EF( r ＞0.3, P ＜0.01 ). Conclusions The velocity of DCM group was lower than that of control group, VFM is a new noninvasive and clinically useful parameter for the evaluation of intracavitary flow dynamics.