血流向量成像技术分析肥厚型心肌病患者左室血流动力学变化的临床研究

Evaluation of left ventricular hemodynamical changes in hypertropic cardiomyopathy patient by vector flow mapping

目的应用血流向量成像(VFM)技术评价肥厚型心肌病患者左室血流动力学变化及室壁整体舒缩功能。方法选取肥厚型心肌病患者(病变组)26例和对照组31例,应用VFM技术分析其快速射血期、减慢射血期及等容舒张期的涡流及流线特征,测量涡流横、纵径及快速射血期二尖瓣水平左室流出道与乳头肌水平左室心腔的速度阶差(ΔV)。结果①与对照组比较,病变组快速射血期、减慢射血期及等容舒张期显示涡流更大、更散乱、持续时间更长,两组间比较病变组涡流横径、纵径值明显大于对照组,差异有统计学意义。②对照组流线起止规律,流线齐整;病变组流线杂乱起止可在左室不同部位。③病变组收缩期左室流出道速度阶差显著高于对照组。结论 VFM技术可直观反映肥厚型心肌病患者左室血流动力学变化,从而为评估心功能提供早期参考。

Objective To evaluate the left ventricular hemodynimics and the overall systolic and diastolic function in hypertropic cardiomyopathy （HCM） patients by vector flow mapping （VFM）. Methods Twenty-six HCM patients and 31 control subjects were enrolled in this study, their transverse and vertical diameter of vortex and the streamline caracteristic in rapid ejection, reduced ejection and isovolumic relaxation phase, along with the velocity gratient （AV） between the left ventricular outflow tract and papillary muscle level in rapid ejection were analyzed by VFM technique. Results （1）Compared with control group, the vortex were bigger, more dispersed and lasted longer in HCM group in rapid ejection, reduced ejection and isovolumic relaxation phase. The transeverse and vetical diameter of vortex measured in HCM group were greater than that in control group, there was significant difference between two groups. （2）Streamline origniated and ended regularly in control group, but disordered streamline started and stopped at different sections of left ventricle in HCM group. （3）The velocity gradient in HCM group was higher than that in control group. Conclusion VFM can provide a visible hemodynamieal change in left ventricle of HCM patients, and it can provide preference for early evaluation of cardiac function.