血流向量成像技术评价房颤患者在心动周期中左心室能量损失特征及相关因素

Flow vector imaging technique to evaluate left ventricular energy loss characteristics and related factors in patients with atrial fibrillation during cardiac cycle

目的探讨血流向量成像技术(VFM)定量评价心房颤动(AF)患者在心动周期中左心室血流动力学的变化。方法60例AF患者作为AF组,同期60例健康志愿者作为对照组;收集2组受试者一般资料及常规超声心动图参数,对2组受试者进行VFM检查,比较2组受试者心动周期中等容收缩期(IC)、收缩早期(ES)、收缩晚期(LS)、等容舒张期(IVRT)、舒张早期(ED)和舒张晚期(LD)的左室能量损失(EL)差异,分析2组受试者左心室EL的变化特征与常规超声参数的相关性。结果与对照组比较,AF组患者左房内径(LAD)、左室舒张末期内径(LVEDD)、左心室舒张末期容积(LVEDV)、左室收缩末期容积(LVESV)、E/e′均升高,差异均有统计学意义(P<0.05),e′低于对照组,差异有统计学意义(P<0.05);与对照组比较,AF组在ES、LS、ED、LD的EL明显升高(P<0.05),左室LS-EL与LVEDD呈明显正相关(r=0.93,P<0.0001),左室ED-EL与LVEDV、E、E/e′呈明显正相关(r=0.93、0.98、0.95,P<0.0001)、与e′呈明显负相关(r=-0.93,P<0.0001),LVEDV与E、E/e′呈明显正相关(r=0.93、0.97,P<0.0001)、与e′呈明显负相关(r=-0.83,P<0.0001),E与e′呈明显负相关(r=-0.88,P<0.0001)、与E/e′呈明显正相关(r=0.98,P<0.0001),e′与E/e′呈明显负相关(r=-0.84,P<0.0001)。结论AF患者左室血流动力学发生紊乱,使心动周期中多个时相的EL升高。

Objective To blood flow vector imaging techniques(VFM)for the quantitative evaluation of left ventricular hemodynamic changes in patients with atrial fibrillation(AF).Methods Sixty patients with AF were included as the AF group,and 60 healthy volunteers served as the control group during the same period.General data and conventional echocardiographic parameters of 2 subjects were collected and VFM examination was performed in 2 groups.The left ventricular energy loss(EL)in middle volume contraction(IC),early systole(ES),late systole(LS),isovolumic relaxation(IVRT),early diastole(ED),and late diastole(LD)in 2 groups were compared,and the correlation between the change characteristics of left ventricular EL and conventional ultrasound parameters in the heart cycle was analyzed in 2 groups.Results Compared with the control group,the left atrial diameter(LAD),left ventricular end-diastolic diameter(LVEDD),left ventricular end-diastolic volume(LVEDV),left ventricular end-systolic volume(LVESV)and E/e′were increased in the AF group,and the differences were statistically significant(P<0.05).e′was lower than that of the control group,and the difference was statistically significant(P<0.05).Compared with the control group,EL in ES,LS,ED,and LD in the AF group was significantly increased(P<0.05).In the AF group,there was a significant positive correlation between left ventricular LS-EL and LVEDD(r=0.93,P<0.0001),and there was the clear positive correlation between left ventricle ED-EL and LVEDV,E and E/e′(r=0.93,0.98,0.95;P<0.0001),and the clear negative correlation(r=-0.93,P<0.0001)in AF group.LVEDV showed a clear positive correlation with E,E/e′(r=0.93,0.97;P<0.0001)and a clear negative correlation with e′(r=-0.83,P<0.0001).E showed a clear negative correlation with e′(r=-0.88,P<0.0001)and a clear positive correlation with E/e′(r=0.98,P<0.0001).There was the clear negative correlation between e′and E/e′(r=-0.84,P<0.0001).Conclusion The left ventricular hemodynamic disturbances in AF patients increase EL in multiple phases during the cardiac cycle.