血流向量成像技术对射血分数保留的主动脉瓣狭窄患者左心室收缩功能的研究

摘要

Objective To quantitatively analyze the changes in left ventricular mean energy loss ( EL ) using blood flow vector imaging ( VFM ) in patients with aortic stenosis retained by ejection fraction . Methods T hirty‐five subjects were selected as the control group ,and 71 patients with aortic stenosis were chosen as the case group ,including mild aortic stenosis ( miAS) group( 23 cases) ,moderate aortic stenosis ( moAS) group( 23 cases) ,and severe arterial stenosis ( seAS) group( 25 cases) . Left atrial anteroposterior diameter ( LAA ) ,left ventricular end‐diastolic diameter ( LVEDD ) ,left ventricular end‐diastolic volume ( LVEDV ) ,left ventricular end‐systolic volume ( LVESV ) ,left ventricular ejection fraction ( LVEF ) and E/A were measured by conventional echocardiography . T he average total EL ( EL‐T ) , average basal segment EL ( EL‐B) ,average middle segment EL ( EL‐M ) and average apical segment EL ( EL‐A ) of each isovolumic contraction phase ( IVC ) and rapid ejection phase ( RE ) were measured by VFM ,and the differences in mean EL among each groups were compared . Results Compared with those in the control group ,average EL‐B ,average EL‐M and average EL‐T in each case group of the left ventricle during IVC and RE were increased ,the average EL‐A in seAS group of the left ventricle during IVC were increased ,and the differences were statistically significant( all P ＜0 .05) . Compared with those in miAS group ,the average EL‐B ,average EL‐M and average EL‐T in seAS group of the left ventricle during IVC and RE were increased ,and the differences were statistically significant ( all P ＜ 0 .05 ) . Compared with those in miAS group ,the average EL‐A in moAS group and seAS group of the left ventricle during RE were increased ,and the differences were statistically significant ( all P ＜ 0 .05 ) . Conclusions VFM technology can directly reflect the hemodynamic changes in the left ventricular chamber of patients with aortic stenosis retained by ejection fraction ,and provide a new method for the evaluation of left ventricular systolic function in patients with aortic stenosis .%目的 应用血流向量成像(VFM )技术定量评价射血分数保留的主动脉瓣狭窄患者左心室平均能量损耗的改变.方法 选取健康人35例作为对照组,主动脉瓣狭窄患者71例作为病例组,其中轻度主动脉瓣狭窄(miAS )组23 例,中度主动脉瓣狭窄(moAS )组 23例,重度主动脉瓣狭窄(seAS)组25例.常规超声心动图测量左心房前后径(LAA ) 、左心室舒张末期内径(LVEDD ) 、左心室舒张末期容积(LVEDV)、左心室收缩末期容积(LVESV)、左心室射血分数(LVEF)、 E峰／A 峰(E／A). VFM技术测量各组左心室等容收缩期及快速射血期平均整体能量损耗(EL‐T)、基底段能量损耗(EL‐B) 、中间段能量损耗(EL‐M )及心尖段能量损耗(EL‐A ) ,比较各组间平均能量损耗的差异.结果 与对照组比较,各病例组等容收缩期及快速射血期平均EL‐B 、 EL‐M及EL‐T均增大, seAS组等容收缩期平均EL‐A增大,差异有统计学意义(均 P ＜0 .05) ;与miAS组相比, seAS组等容收缩期及快速射血期平均EL‐B 、 EL‐M及EL‐T均增大, moAS组、 seAS组快速射血期平均EL‐A增大,差异有统计学意义(均 P ＜0 .05) .结论 VFM技术能够反映射血分数保留的主动脉瓣狭窄患者左心室心腔内的血流动力学改变,为评价主动脉瓣狭窄患者左心室收缩功能提供了一种新方法.