Department of Pediatrics, Kitasato University School of Medicine, Kanagawa, Japan.
Department of Cardiovascular Surgery, Kyoto Prefectural University of Medicine, Kyoto, Japan.
Int J Cardiol. 2017 Oct 1;244:143-150. doi: 10.1016/j.ijcard.2017.06.035. Epub 2017 Jun 13.
Vector flow mapping is a novel echocardiographic flow visualization method, and it has enabled us to quantitatively evaluate the energy loss in the left ventricle (intraventricular energy loss). Although intraventricular energy loss is assumed to be a part of left ventricular workload itself, it is unclear what this parameter actually represents. The aim of the present study was to elucidate the characteristics of intraventricular energy loss.
We enrolled 26 consecutive children with ventricular septal defect (VSD). On echocardiography vector flow mapping, intraventricular energy loss was measured in the apical 3-chamber view. We measured peak energy loss and averaged energy loss in the diastolic and systolic phases, and subsequently compared these parameters with catheterization parameters and serum brain natrium peptide (BNP) level.
Diastolic, peak, and systolic energy loss were strongly and positively correlated with right ventricular systolic pressure (r=0.76, 0.68, and 0.56, p<0.0001, = 0.0001, and 0.0029, respectively) and right ventricular end diastolic pressure (r=0.55, 0.49, and 0.49, p=0.0038, 0.0120, and 0.0111, respectively). In addition, diastolic, peak, and systolic energy loss were significantly correlated with BNP (r=0.75, 0.69 and 0.49, p<0.0001, < 0.0001, and=0.0116, respectively).
In children with VSD, elevated right ventricular pressure is one of the factors that increase energy loss in the left ventricle. The results of the present study encourage further studies in other study populations to elucidate the characteristics of intraventricular energy loss for its possible clinical application.
向量血流图是一种新颖的超声心动图血流可视化方法，它使我们能够定量评估左心室的能量损失（室内能量损失）。虽然室内能量损失被认为是左心室工作量本身的一部分，但尚不清楚该参数实际上代表什么。本研究旨在阐明室内能量损失的特征。
我们纳入了 26 例连续的室间隔缺损（VSD）患儿。在超声心动图向量血流图中，在心尖 3 腔视图中测量室内能量损失。我们测量舒张期和收缩期的峰值能量损失和平均能量损失，随后将这些参数与心导管参数和血清脑钠肽（BNP）水平进行比较。
舒张期、峰值和收缩期能量损失与右心室收缩压呈强正相关（r=0.76、0.68 和 0.56，p<0.0001、=0.0001 和 0.0029，分别）和右心室舒张末期压（r=0.55、0.49 和 0.49，p=0.0038、0.0120 和 0.0111，分别）。此外，舒张期、峰值和收缩期能量损失与 BNP 显著相关（r=0.75、0.69 和 0.49，p<0.0001、<0.0001 和=0.0116，分别）。
在 VSD 患儿中，升高的右心室压力是增加左心室能量损失的因素之一。本研究的结果鼓励在其他研究人群中进行进一步研究，以阐明室内能量损失的特征，为其可能的临床应用提供依据。
