VFM技术测定高血压患者不同时相、节段的左心室血流能量损耗的价值

Value of VFM technique in determination of left ventricular flow energy loss in different phases and segments in hypertensive patients

目的:探讨血流向量成像(VFM)技术定量测定高血压患者不同时相、节段的左心室血流能量损耗(LVFEL)的价值。方法:选择我院2014年1月至2017年1月收治的130例高血压患者为高血压组,另选同期130例正常体检者为健康对照组。根据临床分型,高血压组进一步被为正常构型组(40例)、向心性重构组(56例)、向心性肥厚组(34例)3个亚组。采用VFM技术对各组不同时相、节段的LVFEL进行测定和比较。结果:高血压组不同时相、节段LVFEL均显著高于健康对照组,P均=0.001。与正常构型组比较,向心性重构和向心性肥厚组基底段血流EL [(15.10±1.22)N·m^(-1)·s^(-1)比(17.94±1.28)N·m^(-1)·s^(-1)比(16.76±1.24)N·m^(-1)·s^(-1)]显著升高,且向心性重构组的显著高于向心性肥厚组的,P均=0.001;与正常构型和向心性肥厚组比较,向心性重构组的中间段血流EL [(8.10±1.20)N·m^(-1)·s^(-1)、(8.22±1.18)N·m^(-1)·s^(-1)比(8.94±1.16)N·m^(-1)·s^(-1)]显著升高,P均<0.01;向心性肥厚组心尖段血流EL显著高于正常构型组[(4.59±1.07)N·m^(-1)·s^(-1)比(3.91±1.09)N·m^(-1)·s^(-1)],P=0.006;向心性重构组舒张中期血流EL显著高于正常构型组[(8.87±1.03)N·m^(-1)·s^(-1)比(8.25±1.05)N·m^(-1)·s^(-1)],P=0.006。结论:血流向量成像技术可准确定量测定高血压患者不同时相、不同节段的左心室血流能量损耗,为及早揭示其血流动力学改变提供可靠依据。

Objective:To explore value of vector flow mapping(VFM)technique in quantitative determination of left ventricular flow energy loss(LVFEL)in different phases and segments in hypertensive patients.Methods:A total of130hypertensive patients treated in our hospital from Jan2014to Jan2017were enrolled as hypertension group.Another130healthy subjects undergoing physical examination simultaneously were enrolled as healthy control group.According to clinical pattern,hypertension group was further divided into normal structure group(NS group,n=40),concentric remodeling group(CR group,n=56)and concentric hypertrophy group(CH group,n=34).LVFEL of different phases and segments were measured and compared by VFM technique among all groups.Results:LVFELs of different phases and segments in hypertension group were significantly higher than those of healthy control group,P=0.001all.Compared with NS group,there were significant rise in[(15.10±1.22)N·m-1·s-1vs.(17.94±1.28)N·m-1·s-1vs.(16.76±1.24)N·m-1·s-1]in CR group and CH group,and that of CR group was significantly higher than that of CH group,P=0.001all;compared with NS group and CH group,there was significant rise in middle segment flow EL[(8.10±1.20)N·m-1·s-1,(8.22±1.18)N·m-1·s-1vs.(8.94±1.16)N·m-1·s-1]in CR group,P<0.01all;apical segment flow EL of CH group was significantly higher than that of NS group[(4.59±1.07)N·m-1·s-1vs.(3.91±1.09)N·m-1·s-1],P=0.006;mid-diastolic flow EL of CR group was significantly higher than that of NS group[(8.87±1.03)N·m-1·s-1vs.(8.25±1.05)N·m-1·s-1],P=0.006.Conclusion:Vector flow mapping technique can accurately and quantitatively determine LVFEL in different phases and segments in hypertensive patients,which provides reliable evidence for early revealing hemodynamic changes.