VFM评价Ⅰ级舒张功能减低左室舒张期能量损耗的初步研究

An initial study of left ventricular diastolic energy loss in patients with grade Ⅰ diastolic dysfunction using vector flow mapping

目的 :应用血流向量成像技术(Vector flow mapping,VFM)分析舒张功能正常及Ⅰ级舒张功能减低者左心室舒张期能量损耗(EL)的变化特征,探讨其在评价左心室舒张功能中的临床价值。方法:收集我院体检中心47例成人为研究对象,E/A>1,e’/a’>1者24例(舒张功能正常),E/A<1,e’/a’<1者23例(Ⅰ级舒张功能减低)。VFM模式下采集标准心尖三腔动态彩色多普勒图像,应用DSA-RS1工作站进行脱机分析,分析整个舒张期EL变化并计算舒张期EL的平均值,比较两组差异。结果:舒张功能正常组舒张期左心室EL会出现两个峰值,分别出现在快速充盈期(peak1)和房缩期(peak2)。Ⅰ级舒张功能减低组peak1((27.36±13.91)J/(m^3·s)vs(12.37±9.33)J/(m^3·s),P<0.001)明显降低。peak2两组无统计学意义。舒张功能正常组舒张期EL均值为(10.43±3.84)J/(m^3·s),Ⅰ级舒张功能减低组舒张期EL均值为(7.66±4.12)J/(m^3·s),两组差异具有统计学意义(P<0.05)。结论 :成人左室舒张功能正常者和舒张功能Ⅰ级减低患者EL差异显著,EL是反应左室舒张功能的一个敏感指标。

Objective： To analyze left ventricular diastolic energy loss （EL） in patients with grade I diastolic dysfunction using vector flow mapping（VFM）, and to explore its clinical value in assessment of left ventricular diastolic function. Methods： Forty-seven healthy volunteers from our hospital were include in the study. They were divided into two groups： 24 with E/A〉 1, e＇/a＇ 〉l（nonnal diastolic function）, 23 with E/A〈I, e＇/a＇〈l（grade ] diastolic dysfunction）. Standard apical 3-chamber dy- namic color Doppler images were recorded in VFM mode, and DSA-RSI workstation was used for off-fine analysis. The dif- ference of average diastolic EL was compared between the two groups. Results： During diastole, the EL in left ventricle will appear two peaks, one is in the rapid filling phase（peakl） and the other is in the atrial contraction phase（peak 2）. Compared with the E/AM group, peakl was obviously decreased in E/A〈I group（（27.36±13.91）J/（m3 s） vs （12.37±9.33） J/（m3 s）, P〈O.O01）. The EL value of peak2 was shown no statistical significance. The average diastolic EL for normal diastolic function group and grade I diastolic dysfunction group were （（10.43±3.84） J/（m3.s） and （7.66±4.12） J/（m3 s）, respectively, with a significant differ- ence between two groups （P〈0.05）. Conclusions： There was a significantly difference of left ventrieular EL in adults between normal diastolic function group and grade ] diastolic dysfunction group, EL might be a sensitive index for the evaluation of diastolic dysfunction.