Abstract:Objective: To analyze left ventricular diastolic energy loss(EL) in patients with grade Ⅰ diastolic dysfunction using vector flow mapping(VFM), and to explore its clinical value in assessment of left ventricular diastolic function. Methods: Forty-seven healthy volunteers from our hospital were include in the study. They were divided into two groups: 24 with E/A>1, e’/a’ >1(normal diastolic function), 23 with E/A<1, e’/a’<1(grade Ⅰ diastolic dysfunction). Standard apical 3-chamber dynamic color Doppler images were recorded in VFM mode, and DSA-RS1 workstation was used for off-line analysis. The difference of average diastolic EL was compared between the two groups. Results: During diastole, the EL in left ventricle will appear two peaks, one is in the rapid filling phase(peak1) and the other is in the atrial contraction phase(peak 2). Compared with the E/A>1 group, peak1 was obviously decreased in E/A<1 group((27.36±13.91) J/(m3·s) vs (12.37±9.33) J/(m3·s), P<0.001).The EL value of peak2 was shown no statistical significance. The average diastolic EL for normal diastolic function group and grade Ⅰ diastolic dysfunction group were ((10.43±3.84) J/(m3·s) and (7.66±4.12) J/(m3·s), respectively, with a significant difference between two groups(P<0.05). Conclusions: There was a significantly difference of left ventricular EL in adults between normal diastolic function group and grade Ⅰ diastolic dysfunction group, EL might be a sensitive index for the evaluation of diastolic dysfunction.
朱晓丽,徐 磊,刘丽文,孙 超,赵 丹. VFM评价Ⅰ级舒张功能减低左室舒张期能量损耗的初步研究[J]. 中国临床医学影像杂志, 2017, 28(11): 802-804.
ZHU Xiao-li, XU Lei, LIU Li-wen, SUN Chao, ZHAO Dan. An initial study of left ventricular diastolic energy loss in patients with
grade Ⅰ diastolic dysfunction using vector flow mapping. JOURNAL OF CHINA MEDICAL IMAGING, 2017, 28(11): 802-804.
[1]鄢磊,阮琴韵. 舒张功能不全超声心动图分级和左室充盈压的评价[J]. 中华高血压杂志,2008,16(2):106-108.
[2]冯玉红. 血流向量成像技术临床研究进展[J]. 中华超声影像学杂志,2015,24(10):916-919.
[3]刘学兵,马荣川,欧阳征鹏,等. 血流向量成像技术分析高血压合并主动脉瓣关闭不全的能量损耗[J]. 中国医学影像技术,2016,32(2):235-238.
[4]Nagueh SF, Smiseth OA, Appleton CP, et al. Recommendations for the evaluation of left ventricular diastolic function by echocardiography: an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging[J]. Eur Heart J Cardiovasc Imaging, 2016, 17(12): 1321-1360.
[5]邓燕,郭盛兰,马国添,等. 实时三维超声心动图定量评估左室舒张功能的研究[J]. 中国临床医学影像杂志,2010,21(3):205-207.
[6]Tighe DA, Vinch CS, Hill JC, et al. Influence of age on assessment of diastolic function by Doppler tissue imaging[J]. Am J Cardiol, 2003, 91(2): 254-257.
[7]Munagala VK, Jacobsen SJ, Mahoney DW, et al. Association of newer diastolic function parameters with age in healthy subjects: a population-based study[J]. J Am Soc Echocardiogr, 2003, 16(10): 1049-1056.
[8]Chen R, Zhao BW, Wang B, et al. Assessment of left ventricular hemodynamics and function of patients with uremia by vortex formation using vector flow mapping[J]. Echocardiography, 2012, 29(9): 1081-1090.
[9]Hayashi T, Itatani K, Inuzuka R, et al. Dissipative energy loss within the left ventricle detected by vector flow mapping in children: normal values and effects of age and heart rate[J]. J Cardiol, 2015, 66(5): 403-410.