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目的应用血流向量图(vector flow mapping,VFM)比较心力衰竭(心衰)患者与正常人左室等容收缩期血流动力学特点。方法对照组包括健康志愿者51例,心衰组包括左室射血分数<45%的扩张性心肌病患者57例。心尖左室长轴观记录左室彩色多普勒血流信号,应用VFM测量并比较等容收缩期初始帧和终末帧左室腔内涡流流率与面积。结果对照组舒张末期左室涡流经过等容收缩期后面积无显著性变化,但流率显著降低(P<0.01);所有涡流范围均达到左室基底部。而心衰组经过等容收缩期后,涡流面积、流率均显著降低(均P<0.05);仅有25例(44%)患者涡流范围可达到左室基底部。校正心腔大小的影响后,等容收缩期末左室涡流的面积和流率心衰组均小于对照组(均P<0.01)。结论经过等容收缩期后,心衰患者左室涡流的大小与流率均显著降低,且低于正常心脏。
Objective To compare the hemodynamics of left ventricular systolic left ventricular systolic function in patients with heart failure (CHF) and normal subjects by using vector flow mapping (VFM). Methods The control group consisted of 51 healthy volunteers and 57 patients with heart failure including dilated cardiomyopathy with left ventricular ejection fraction <45%. Left ventricular color Doppler flow signals were recorded by long axis view of left atrium. VFM was used to measure and compare the vortex flow rate and area in the left ventricular cavity of the initial and final isovolumetric systolic. Results There was no significant change in the area of left ventricular end diastolic vortex after isovolumic contraction in control group, but the flow rate was significantly decreased (P <0.01). All eddy currents reached the base of left ventricle. However, vasospasm area and flow rate were significantly decreased in patients with heart failure (all P <0.05) after isovolumic contraction; in only 25 patients (44%), the vortex area reached the base of left ventricle. After adjusting for the influence of the size of the cardiac chamber, LV area and flow rate in the isovolumic group at the end of isovolumic systolic phase were all less than those in the control group (all P <0.01). Conclusions After the isovolumic contraction period, the magnitude and flow rate of left ventricular vortex in patients with heart failure were significantly lower than those in normal heart.