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心脏病患者升主动脉的三维横截面速度分布

Three-dimensional cross-sectional velocity distribution in the ascending aorta in cardiac patients.

作者信息

Kvitting P, Hessevik I, Matre K, Segadal L

机构信息

Surgical Research Laboratory, Department of Surgery, University of Bergen, Haukeland Hospital, Norway.

出版信息

Clin Physiol. 1996 May;16(3):239-58. doi: 10.1111/j.1475-097x.1996.tb00572.x.

Abstract

Knowledge of the distribution of velocities across the ascending aorta is important for measurements of cardiac output; for understanding the function of normal and diseased valves and for the evaluation of prosthetic valves. The aim of this study was to investigate, in detail, the spatial distribution of axial velocities in the human ascending aorta, covering a nearly complete cross-section of the lumen in a time continuous modus. During open-heart surgery, blood velocities in the ascending aorta were mapped in 10 patients. All patients had aortic valves with no significant clinical evidence of disease. Pulsed Doppler ultrasound technique was used to measure blood velocity using an intraluminal probe with a 1 mm, 10 MHz crystal connected to a position-sensitive device. The distribution of blood velocity in the aorta 6-8 cm above the valve was characterized by a skewed and irregular peak systolic flow, with maximum velocity posteriorly. There was a positive correlation (r=0.854, P<0.002) between the maximum skewness slope and the stroke volume. Significant retrograde flow was recorded in all patients in the left posterior part of aorta in late systole and early diastole. The rotation of the point of maximal velocity was anticlockwise in six patients, clockwise in three and alternating in one. The present study shows that there is a considerable individual variation in the velocity distribution in the ascending aorta, with no plane symmetric features, and that large sampling volumes are required for reliable estimates of mean velocity.

摘要

了解升主动脉内速度的分布对于心输出量的测量、理解正常和病变瓣膜的功能以及评估人工瓣膜至关重要。本研究的目的是详细研究人体升主动脉中轴向速度的空间分布,以时间连续模式覆盖几乎完整的管腔横截面。在心脏直视手术期间,对10例患者的升主动脉血流速度进行了测绘。所有患者的主动脉瓣均无明显疾病临床证据。使用脉冲多普勒超声技术,通过连接到位置敏感装置的1毫米、10兆赫晶体的腔内探头测量血流速度。瓣膜上方6-8厘米处主动脉内血流速度分布的特征是收缩期峰值血流呈偏态且不规则,最大速度位于后方。最大偏斜斜率与每搏输出量之间存在正相关(r=0.854,P<0.002)。在所有患者中,均在收缩期末期和舒张早期记录到主动脉左后部有明显的逆流。6例患者最大速度点的旋转为逆时针方向,3例为顺时针方向,1例为交替方向。本研究表明,升主动脉内速度分布存在相当大的个体差异,无平面对称特征,并且需要大采样体积才能可靠估计平均速度。

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