CAJ | 학술논문

目的：探讨慢性心力衰竭（CHF）患者左心室内血流自收缩射血向舒张充盈血流逆转的规律。资料与方法选取25例CHF患者作为CHF组，并选取28例健康人作为对照组。测定射血-充盈血流逆转间期（FRI）、校正射血-充盈血流逆转间期（CFRI）、射血-充盈血流逆转流率（FRR）、左心室射血期峰值流率（FRPE），比较两组左心室流体力学参数的差异。结果与对照组相比，CHF患者左心室涡流FRI延长[（71±13）ms 对（113±30）ms，P<0.05）]，FRR 减低[（46.85±21.35）cm2/s 对（27.90±16.77）cm2/s，P<0.05）]，FRPE减低[（74.54±9.10）cm2/s对（41.12±17.25）cm2/s， P<0.05）]。FRI、CFRI与Tei指数呈正相关（r=0.812、0.849，P<0.01），FRI与左心室射血分数（LVEF）、短轴缩短率（FS）、每搏量（SV）、心输出量（CO）、心指数（CI）呈负相关（r=－0.646~－0.515，P<0.05、P<0.01）；CFRI与LVEF、FS、SV、CO、CI呈负相关（r=－0.685~－0.456，P<0.05、P<0.01）；FRR与Tei指数呈负相关（r=－0.604，P<0.05），与LVEF、FS、SV、CO、CI呈正相关（r=0.503~0.812， P<0.05、P<0.01）；FRPE与Tei指数呈负相关（r=－0.734，P<0.01），与LVEF、FS、SV、CO、CI呈正相关（r=0.557~0.776，P<0.05、P<0.01）。结论超声血流向量成像能够直观地显示并定量分析CHF患者左心室的流体力学变化，左心室内血流方向逆转效率可以作为判断CHF治疗效果的指标之一。
목적：탐토만성심력쇠갈（CHF）환자좌심실내혈류자수축사혈향서장충영혈류역전적규률。자료여방법선취25례CHF환자작위CHF조，병선취28례건강인작위대조조。측정사혈-충영혈류역전간기（FRI）、교정사혈-충영혈류역전간기（CFRI）、사혈-충영혈류역전류솔（FRR）、좌심실사혈기봉치류솔（FRPE），비교량조좌심실류체역학삼수적차이。결과여대조조상비，CHF환자좌심실와류FRI연장[（71±13）ms 대（113±30）ms，P<0.05）]，FRR 감저[（46.85±21.35）cm2/s 대（27.90±16.77）cm2/s，P<0.05）]，FRPE감저[（74.54±9.10）cm2/s대（41.12±17.25）cm2/s， P<0.05）]。FRI、CFRI여Tei지수정정상관（r=0.812、0.849，P<0.01），FRI여좌심실사혈분수（LVEF）、단축축단솔（FS）、매박량（SV）、심수출량（CO）、심지수（CI）정부상관（r=－0.646~－0.515，P<0.05、P<0.01）；CFRI여LVEF、FS、SV、CO、CI정부상관（r=－0.685~－0.456，P<0.05、P<0.01）；FRR여Tei지수정부상관（r=－0.604，P<0.05），여LVEF、FS、SV、CO、CI정정상관（r=0.503~0.812， P<0.05、P<0.01）；FRPE여Tei지수정부상관（r=－0.734，P<0.01），여LVEF、FS、SV、CO、CI정정상관（r=0.557~0.776，P<0.05、P<0.01）。결론초성혈류향량성상능구직관지현시병정량분석CHF환자좌심실적류체역학변화，좌심실내혈류방향역전효솔가이작위판단CHF치료효과적지표지일。
PurposeTo explore the left ventricle flow propagation process in patients with chronic heart failure (CHF) using velocity flow mapping. Materials and Methods Patients with CHF (n=25) were selected as CHF group. Healthy subjects (n=28) were chosen as the control group. Flow reversal interval (FRI), flow reversal rate (FRR), corrected flow reversal rate (CFRI) and flow rate in peak ejection (FRPE) were measured. Parameters related to the vortex in CHF group were compared with that in the control group. Results Compared with the control group, FRI was longer [(71±13) msvs. (113±30) ms, P<0.05], FRR and FRPE were lower [(46.85±21.35) cm2/svs. (27.90±16.77) cm2/s;(74.54±9.10) cm2/svs. (41.12±17.25) cm2/s,P<0.05] in CHF group. FRI and CFRI were positively correlated with the Tei index (r=0.812 and 0.849,P<0.01). FRI was negatively correlated with LVEF, FS, SV, CO, CI (r=-0.646--0.515,P<0.05 orP<0.01). CFRI was negatively correlated with LVEF, FS, SV, CO and CI (r=-0.685--0.456,P<0.05 orP<0.01); FRR was negatively correlated with Tei index (r=-0.604,P<0.05), and was positively correlated with LVEF, FS, SV, CO and CI (r=0.503-0.812,P<0.05 orP<0.01);FRPE was negatively correlated with Tei index (r=-0.734,P<0.01), and were positively correlated with LVEF, FS, SV, CO and CI (r=0.557-0.776,P<0.05 orP<0.01).Conclusion Velocity flow mapping can demonstratecardiac hydromechanics in patients with chronic heart failure. The heart blood flow direction reversal efficiency may be a new method for diagnosis and treatment evaluation.