超声向量血流标测技术评价Graves病患者快速射血期左心室腔内血流动力学改变
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四川省科技厅项目(2016TD0017, 2017TD0015)


Assessment of hemodynamics of left ventric during rapid ejection period in Graves patients using ultrasonic vector flow mapping
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    【摘要】 目的 应用超声向量血流标测(VFM)技术评价Graves病(GD)快速射血期左心室腔内血流动力学改变。方法 GD患者83例病例组,并按心率(HR)分为两组:HT1组40例(HR 100次/分),HT2组43例(HR≥100次/分);对照组: 健康志愿者40例。在机测量收缩末期左心房前后径(LAD)、舒张末期左心室前后径(LVDD)、二尖瓣舒张早期最大血流速度(E)、二尖瓣心房收缩期最大血流速度(A)、二尖瓣瓣环舒张早期运动速度(e)、并计算出E/A以及E/e;采用Simpsonn双平面法测出左心室射血分数(LVEF);在VFM成像模式下测量并比较三组快速射血期基底段、中间段及心尖段峰值流量(Fs)、负向总流量(SQ)、峰值流速(Vs);并将三节段Fs、SQ、Vs均值与促甲状腺激素(TSH)、游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)和LVEF进行相关性分析。结果 HT1组与HT2组基底段、中间段、心尖段的Fs、SQ、Vs均高于对照组(P<005),且HT2组相关参数均高于HT1组(P<005);Fs、SQ、Vs与FT3的相关系数分别为0390、0381、0390(P<001),与FT4的相关系数分别为0421、0484、0470(P<001),与LVEF的相关系数分别为0385、0416、0464(P<001)。结论 VFM技术可直观定量评价GD患者快速射血期左心室腔内血流动力学变化,GD患者心率正常时左心室腔内血流量与血流速度已经增快,此时应进行干预减轻心脏容量负荷;左心室腔内血流量及血流速度与FT3、FT4和LVEF正相关。

    Abstract:

    【Abstract】 Objecyive To probe the hemodynamic changes of left ventric (LV) and assess left ventricular systolic function during the rapid ejection period of Graves disease using ultrasonic vector flow mapping (VFM). Methods Eightythree GD patients were divided into HT1 (forty patients, HR 100 times per minute and HT2 (fortythree patients, HR>100 times per minute). Forty healthy volunteers were taken as the control group. Left atrial diameter measuring machine (LAD), left ventricular diameter (LVEDD) mitral early diastolic peak velocity (E), the maximum blood flow velocity of mitral valve (A) and atrial systolic mitral annular early diastolic velocity (E) were measured. Left ventricular ejection fraction (LVEF) was obtained with Simpson method in equipment. Systolic flow (Fs),negative rate (SQ), peak velocity (Vs) of basal, middle and apical levels of LV were compared between the three groups in rapid ejection phase with VFM. Correlation analysis was performed among Fs, SQ, Vs and FT3, FT4, LVEF of GD patients. Results Value of Fs, SQ, Vs of basal, middle and apical levels in HT1 and HT2 groups were significantly higher than those of control group (P< 001). In three groups, Fs, SQ and Vs gradually decreased from basal to apical segment (P< 005). Positive correlation was revealed among Fs, SQ, Vs and FT3 (r=0390、0381、0390, P< 001), FT4 (r=0421、0484、0470, P< 001), LVEF (r=0385、0416、0464, P< 001) of GD patients. Conclusion VFM technology could be used to provide more precise intuitive information about the changes of hemodynamics of left ventricular during the rapid ejection phase, and intracardiac hemodynamics of GD patients have been changed even the heart rate is normal, indicates that those patients should be treatment properly. The left ventricular blood flow and blood flow velocity are positively correlated with FT3, FT4 and LVEF.

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  • 在线发布日期: 2018-04-18
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