Zhang Haibin, Liu Liwen, Chen Lulu, Ma Na, Zhou Liping, Liu Ying, Li Zhiguo, Liu Chengguo, Hou Rui, Zhu Suyang
Department of Ultrasound, PLA 210th Hospital, Dalian, China.
Echocardiography. 2013 Jan;30(1):27-36. doi: 10.1111/j.1540-8175.2012.01806.x. Epub 2012 Sep 18.
The purpose of this study was to assess the evolution of intraventricular vortex during left ventricular (LV) ejection.
Vector flow mapping was performed in 51 patients with coronary artery disease and LV ejection fraction (EF) >50%, 70 patients with EF <50% (13 with coronary artery disease and 57 with dilated cardiomyopathy), and 62 healthy volunteers.
In normals and patients with EF >50%, the intraventricular vortex dissipated quickly during early ejection. In patients with EF <50%, the vortex stayed mainly at apex and persisted for a significantly longer time. The evolution of vortex during ejection was significantly correlated with QRS width, EF, fractional shortening, LV outflow velocity time integral, wall motion score index (WMSI), LV dimensions, left atrial diameter, and diastolic mitral annular velocities. LV end-diastolic short diameter and WMSI were the independent determinants of the duration of vortex (R(2) = 0.482, P < 0.001). End-systolic short diameter and apical WMSI were the independent determinants of duration of vortex corrected for ejection time (R(2) = 0.565, P < 0.001). End-systolic short diameter was the independent determinant of percentage change in vortex area during early ejection (R(2) = 0.355, P < 0.001). End-systolic short diameter and ejection time were the independent determinants of percentage change in vortex flow volume (R(2) = 0.415, P < 0.001).
In patients with LV systolic dysfunction, the vortex persists during ejection and stays mainly at apex. The vortex evolution during ejection is closely associated with LV dimensions and functions.
本研究旨在评估左心室射血期间心室内涡流的演变。
对51例冠心病且左心室射血分数（EF）>50%的患者、70例EF<50%的患者（13例冠心病患者和57例扩张型心肌病患者）以及62名健康志愿者进行向量血流图检查。
在正常人和EF>50%的患者中，心室内涡流在射血早期迅速消散。在EF<50%的患者中，涡流主要停留在心尖并持续显著更长时间。射血期间涡流的演变与QRS波宽度、EF、缩短分数、左心室流出道速度时间积分、室壁运动评分指数（WMSI）、左心室尺寸、左心房直径和舒张期二尖瓣环速度显著相关。左心室舒张末期短径和WMSI是涡流持续时间的独立决定因素（R² = 0.482，P < 0.001）。收缩末期短径和心尖WMSI是经射血时间校正后涡流持续时间的独立决定因素（R² = 0.565，P < 0.001）。收缩末期短径是射血早期涡流面积百分比变化的独立决定因素（R² = 0.355，P < 0.001）。收缩末期短径和射血时间是涡流流量百分比变化的独立决定因素（R² = 0.415，P < 0.001）。
在左心室收缩功能不全的患者中，涡流在射血期间持续存在且主要停留在心尖。射血期间涡流的演变与左心室尺寸和功能密切相关。
