Department of Geriatrics, The First Affiliated Hospital of Nanjing Medical University, No. 300 Guangzhou Road, Nanjing, 210029, China.
Department of Epidemiology and Biostatistics, School of Public Health, Nanjing Medical University, No. 101 Longmian Avenue, Nanjing, 211166, China.
Clin Rheumatol. 2021 Oct;40(10):4049-4060. doi: 10.1007/s10067-021-05747-y. Epub 2021 Apr 26.
Compare the intraventricular hemodynamics of 60 females with systemic lupus erythematosus (SLE) and 61 healthy female controls, and determine cardiac function changes using vector flow mapping (VFM).
To determine the effect of pulmonary artery pressure changes on left ventricular function, SLE patients were divided into a normal pulmonary artery pressure group (S1, n=24) and an elevated pulmonary artery pressure group (S2, n=36). The energy loss (EL) at each segment of the left ventricular chamber (total, basal, middle, and apical segments) during each period of the cardiac cycle (isovolumic contraction, rapid ejection, rapid filling, reduced filling, atrial contraction) was determined.
The S1 group had significantly more vortices than the control group during the rapid ejection, rapid filling, and atrial contraction periods (p<0.01), and the maximum vortex areas in the S1 and S2 groups were smaller than in the control group during rapid filling and atrial contraction periods (p<0.05). Compared with the control group, the S2 group had greater EL during the systole and diastole periods (p<0.01). EL in the S1 group was significantly greater than in the control group during systole (p<0.01). During the rapid filling period, the EL was positively correlated with septal E' (r=0.784, p<0.01), and during the atrial contraction period, EL was positively correlated with septal E/e' (r=0.812, p<0.01) and A (r=0.715, p<0.01).
VFM of patients with SLE can comprehensively, rapidly, and efficiently evaluate changes of myocardial mechanics and intracardiac hemodynamics and provide quantitative analysis of complex intracardiac blood flow. Key points • Vector flow mapping (VFM) is a new non-invasive ultrasound technique that evaluates changes of myocardial mechanics and intracardiac hemodynamics, and provides quantitative analysis of complex intracardiac blood flow. • This study showed that vortex and energy loss may provide more sensitive detection of cardiac dysfunction than conventional echocardiographic indexes in patients with systemic lupus erythematosus.
比较 60 例系统性红斑狼疮(SLE)女性患者和 61 名健康女性对照者的心室室内血流动力学,并使用向量血流图(VFM)确定心脏功能变化。
为了确定肺动脉压变化对左心室功能的影响,将 SLE 患者分为肺动脉压正常组(S1,n=24)和肺动脉压升高组(S2,n=36)。在心动周期的每个时期(等容收缩期、快速射血期、快速充盈期、充盈减少期、心房收缩期),确定左心室腔各节段(总节段、基底节段、中段和心尖段)的能量损耗(EL)。
S1 组在快速射血期、快速充盈期和心房收缩期的涡流明显多于对照组(p<0.01),且 S1 和 S2 组在快速充盈期和心房收缩期的最大涡流面积小于对照组(p<0.05)。与对照组相比,S2 组在收缩期和舒张期的 EL 更大(p<0.01)。与对照组相比,S1 组在收缩期的 EL 明显更大(p<0.01)。在快速充盈期,EL 与室间隔 E'呈正相关(r=0.784,p<0.01),在心房收缩期,EL 与室间隔 E/e'和 A 呈正相关(r=0.812,p<0.01;r=0.715,p<0.01)。
SLE 患者的 VFM 可全面、快速、有效地评估心肌力学和心室内血流动力学变化,并提供复杂心内血流的定量分析。关键点:•向量血流图(VFM)是一种新的非侵入性超声技术,可评估心肌力学和心室内血流动力学变化,并提供复杂心内血流的定量分析。•本研究表明,与传统超声心动图指标相比,涡流和能量损耗可能更敏感地检测系统性红斑狼疮患者的心脏功能障碍。