Li Qiaozhen, Huang Liang, Ma Na, Li Zhiguo, Han Yu, Wu Ling, Zhang Xiaoxia, Li Yiwei, Zhang Haibin
Graduate School of Dalian Medical University, Dalian, China.
Department of Urinary Surgery, PLA 967th Hospital, Dalian, China.
Echocardiography. 2019 Mar;36(3):558-566. doi: 10.1111/echo.14277. Epub 2019 Feb 6.
The purpose of this study was to investigate the relationship between the vortex in left ventricle (LV) during the isovolumic contraction (IVC) period and the preejectional flow velocity in LV outflow tract (V ).
Color Doppler loops were acquired for vector flow mapping in apical long-axis view in 76 patients with dilated cardiomyopathy, 61 patients with coronary artery disease and 36 healthy controls.
All normals exhibited an IVC vortex reaching the LV base. V was significantly related to IVC vortex area flux, transmitral A velocity, mitral annular a' velocity and E/e' ratio, respectively. Transmitral A velocity was the only independent predictor of V (R = 0.292, P = 0.001). In patients the IVC vortex could reach the LV base, middle, or apex. V was significantly related to range, area and area flux of the IVC vortex, LV size, LVEF, mitral annular velocities, E/e' ratio, transmitral A velocity, and IVC time, respectively. Range and corrected area flux of the IVC vortex, LV end-systolic short diameter, and IVC time were independent predictors of V (R = 0.608, P < 0.001).
In normals, the transmitral A velocity (momentum) is efficiently transferred from mitral orifice to LV outflow tract by a normally formed IVC vortex, and transmitral A velocity is the only independent predictor of V . However, in patients with a wide range of LV enlargement and dysfunction, the momentum transfer is associated with not only the LV dimension and function, but also the range and volume of the IVC vortex.
本研究旨在探讨等容收缩期左心室（LV）内的涡流与左心室流出道射血前期血流速度（V）之间的关系。
对76例扩张型心肌病患者、61例冠心病患者和36名健康对照者，采用彩色多普勒环在心底长轴视图下进行矢量血流图采集。
所有正常受试者均表现出一个到达左心室底部的等容收缩期涡流。V分别与等容收缩期涡流面积通量、二尖瓣A峰流速、二尖瓣环a'峰流速及E/e'比值显著相关。二尖瓣A峰流速是V的唯一独立预测因子（R = 0.292，P = 0.001）。在患者中，等容收缩期涡流可到达左心室底部、中部或心尖。V分别与等容收缩期涡流的范围、面积和面积通量、左心室大小、左心室射血分数、二尖瓣环速度、E/e'比值、二尖瓣A峰流速及等容收缩期时间显著相关。等容收缩期涡流的范围和校正面积通量、左心室收缩末期短径及等容收缩期时间是V的独立预测因子（R = 0.608，P < 0.001）。
在正常受试者中，二尖瓣A峰流速（动量）通过正常形成的等容收缩期涡流有效地从二尖瓣口传递至左心室流出道，且二尖瓣A峰流速是V的唯一独立预测因子。然而，在左心室扩大和功能障碍范围广泛的患者中，动量传递不仅与左心室大小和功能有关，还与等容收缩期涡流的范围和容积有关。
