Zhou Bin-Yu, Xie Ming-Xing, Wang Jing, Wang Xin-Fang, Lv Qing, Liu Man-Wei, Kong Shuang-Shuang, Zhang Ping-Yu, Liu Jin-Feng
Department of Ultrasound, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan Department of Ultrasound, Shandong Provincial Qianfoshan Hospital, Shandong University, Jinan, China.
Medicine (Baltimore). 2017 Apr;96(17):e6711. doi: 10.1097/MD.0000000000006711.
Intraventricular hydrodynamics plays an important role in evaluating cardiac function. Relationship between diastolic vortex and left ventricular (LV) filling is still rarely elucidated. The aim of this study was to evaluate the evolution of vortex during diastole in hyperthyroidism (HT) and explore the alteration of hydromechanics characteristics with sensitive indexes.Forty-three patients diagnosed with HT were classified into 2 groups according to whether myocardial damage existed: simple hyperthyroid group (HT1, n = 21) and thyrotoxic cardiomyopathy (HT2, n = 22). Twenty-seven age- and gender-matched healthy volunteers were enrolled as the control group. Offline vector flow mapping (VFM model) was used to analyze the LV diastolic blood flow patterns and fluid dynamics. Hemodynamic parameters, vortex area (A), circulation (C), and intraventricular pressure gradient (ΔP), in different diastolic phases (early, mid, and late) were calculated and analyzed.HT2, with a lower E/A ratio and left ventricular ejection fraction (LVEF), had a larger left atrium diameter (LAD) compared with those of the control group and HT1 (P < .05). Compared with the control group, the vortex size and strength, intraventricular pressure gradient during early and mid-diastole were higher in HT1 and lower in HT2 (P < .05). And in late diastole, the vortex size and strength, intraventricular pressure gradient of HT2 became higher than those of the control group (P < .05). Good correlation could be found between CE and E/A (P < .05), CM and ΔPM (P < .01), CL and FT3 (P < .05).VFM is proven practical for detecting the relationship between the changes of left ventricular diastolic vortex and the abnormal left ventricular filling.
心室内流体动力学在评估心脏功能中起着重要作用。舒张期涡流与左心室（LV）充盈之间的关系仍鲜有阐明。本研究的目的是评估甲状腺功能亢进症（HT）患者舒张期涡流的演变，并通过敏感指标探索流体力学特征的改变。43例确诊为HT的患者根据是否存在心肌损伤分为2组：单纯甲状腺功能亢进组（HT1，n = 21）和甲状腺毒症性心肌病组（HT2，n = 22）。27名年龄和性别匹配的健康志愿者作为对照组。采用离线矢量血流图（VFM模型）分析左心室舒张期血流模式和流体动力学。计算并分析不同舒张期（早期、中期和晚期）的血流动力学参数、涡流面积（A）、环流量（C）和心室内压力梯度（ΔP）。HT2组的E/A比值和左心室射血分数（LVEF）较低，与对照组和HT1组相比，左心房直径（LAD）更大（P <.05）。与对照组相比，HT1组舒张早期和中期的涡流大小和强度、心室内压力梯度较高，HT2组较低（P <.05）。在舒张晚期，HT2组的涡流大小和强度、心室内压力梯度高于对照组（P <.05）。CE与E/A（P <.05）、CM与ΔPM（P <.01）、CL与FT3（P <.05）之间存在良好的相关性。VFM被证明可用于检测左心室舒张期涡流变化与左心室异常充盈之间的关系。
