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[向量血流图在阵发性心房颤动患者左心室内压差评估中的初步价值]

[The preliminary value of vector flow mapping on assessment of left intraventricular pressure difference in patients with paroxysmal atrial fibrillation].

作者信息

Liu Mei, Cai Yuyan, Huang He, Zhong Yue, Wang Fang

机构信息

Department of Cardiology, West China Hospital, Sichuan University, Chengdu 610041, P.R.China.

出版信息

Sheng Wu Yi Xue Gong Cheng Xue Za Zhi. 2021 Apr 25;38(2):310-316. doi: 10.7507/1001-5515.202011004.

DOI:10.7507/1001-5515.202011004
PMID:33913291
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9927684/
Abstract

This study aims to explore the intraventricular pressure difference (IVPD) within left ventricle in patients with paroxysmal atrial fibrillation (PAF) by using the relative pressure imaging (RPI) of vector flow mapping (VFM). Twenty patients with paroxysmal atrial fibrillation (PAF) and thirty control subjects were enrolled in the study. Systolic and diastolic IVPD derived from VFM within left ventricle and conventional echocardiographic parameters were analyzed. It was found that the B-A IVPD of left ventricle in PAF patients showed the same pattern as controls-single peak and single valley during systole and double peaks and double valleys during diastole. Basal IVPD was the main component of base to apex IVPD (B-A IVPD). The isovolumetric systolic IVPD was associated with early systolic IVPD, early systolic IVPD was associated with late systolic IVPD, and late systolic IVPD was associated with isovolumic diastolic IVPD (all < 0.05). The B-A IVPD and basal IVPD during isovolumetric systole, early systole, late systole and isovolumetric diastole in PAF patients significantly decreased (all < 0.05). The study shows that the B-A IVPD pattern of the PAF group is the same as controls, but systolic B-A IVPD and basal IVPD are significantly reduced in PAF patients. VFM-derived RPI can evaluate left ventricular IVPD in PAF patients, providing a visually quantitative method for evaluating left ventricular hemodynamic mechanics in the patients with PAF.

摘要

本研究旨在通过使用向量血流图(VFM)的相对压力成像(RPI)来探究阵发性心房颤动(PAF)患者左心室内的心室压差(IVPD)。本研究纳入了20例阵发性心房颤动(PAF)患者和30例对照者。分析了源自左心室内VFM的收缩期和舒张期IVPD以及传统超声心动图参数。结果发现,PAF患者左心室的B - A IVPD与对照组表现出相同的模式——收缩期为单峰单谷,舒张期为双峰双谷。基底IVPD是心底至心尖IVPD(B - A IVPD)的主要组成部分。等容收缩期IVPD与收缩早期IVPD相关,收缩早期IVPD与收缩晚期IVPD相关,收缩晚期IVPD与等容舒张期IVPD相关(均P<0.05)。PAF患者在等容收缩期、收缩早期、收缩晚期和等容舒张期的B - A IVPD和基底IVPD显著降低(均P<0.05)。研究表明,PAF组的B - A IVPD模式与对照组相同,但PAF患者的收缩期B - A IVPD和基底IVPD显著降低。VFM衍生的RPI可以评估PAF患者的左心室IVPD,为评估PAF患者的左心室血流动力学机制提供一种直观的定量方法。

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本文引用的文献

1
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Heart Vessels. 2021 Jan;36(1):92-98. doi: 10.1007/s00380-020-01664-3. Epub 2020 Jul 6.
2
Atrial Fibrillation-Mediated Cardiomyopathy.心房颤动相关性心肌病。
Circ Arrhythm Electrophysiol. 2019 Dec;12(12):e007809. doi: 10.1161/CIRCEP.119.007809. Epub 2019 Dec 12.
3
Non-invasive intraventricular pressure differences estimated with cardiac MRI in subjects without heart failure and with heart failure with reduced and preserved ejection fraction.在无心力衰竭和射血分数降低及保留心力衰竭的受试者中,用心脏 MRI 估计的无创性心室内压力差异。
Open Heart. 2019 Oct 9;6(2):e001088. doi: 10.1136/openhrt-2019-001088. eCollection 2019.
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Guidelines for Performing a Comprehensive Transthoracic Echocardiographic Examination in Adults: Recommendations from the American Society of Echocardiography.成人经胸超声心动图全面检查操作指南:美国超声心动图学会的建议
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Accuracy and limitations of vector flow mapping: left ventricular phantom validation using stereo particle image velocimetory.向量流映射的准确性和局限性:使用立体粒子图像测速技术对左心室模型进行验证
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2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS.2016年欧洲心脏病学会(ESC)与欧洲心胸外科学会(EACTS)合作制定的心房颤动管理指南。
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Korean J Radiol. 2016 Jul-Aug;17(4):445-62. doi: 10.3348/kjr.2016.17.4.445. Epub 2016 Jun 27.
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MRI Assessment of Diastolic and Systolic Intraventricular Pressure Gradients in Heart Failure.心力衰竭时舒张期和收缩期心室内压力梯度的MRI评估
Curr Heart Fail Rep. 2016 Feb;13(1):37-46. doi: 10.1007/s11897-016-0281-0.
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Cardiac Fibrosis in Patients With Atrial Fibrillation: Mechanisms and Clinical Implications.心房颤动患者的心肌纤维化:机制与临床意义。
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Altered spatial distribution of the diastolic left ventricular pressure difference in heart failure.心力衰竭时舒张期左心室压力差的空间分布改变。
J Am Soc Echocardiogr. 2015 May;28(5):597-605.e1. doi: 10.1016/j.echo.2015.01.002. Epub 2015 Feb 15.