| 刘娟,尹立雪,孟庆国,徐芸,王斯佳,严霜霜.超声血流向量成像联合二维组织追踪技术评价心房颤动患者左心房心肌功能及血流能量损耗[J].中国医学影像技术,2020,36(5):680~685 |
| 超声血流向量成像联合二维组织追踪技术评价心房颤动患者左心房心肌功能及血流能量损耗 |
| Assessment of left atrial myocardial function and blood flow energy loss in atrial fibrillation patients using ultrasonic vector flow mapping combined with two-dimensional tissue tracking |
| 投稿时间：2019-09-16 修订日期：2020-03-02 |
| DOI：10.13929/j.issn.1003-3289.2020.05.009 |
| 中文关键词: 心房颤动 心房功能,左 超声检查 二维组织追踪显像 能量损耗 |
| 英文关键词:atrial fibrillation atrial function,left ultrasonography two-dimensional tissue tracking energy loss |
| 基金项目:国家自然科学基金（81671852）、四川省科技厅项目（2016TD0017、2017TD0015）。 |
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| 中文摘要: |
| 目的 应用超声血流向量成像技术（VFM）联合二维组织追踪技术（2DTT）同步评价不同类型心房颤动（AF）患者左心房心肌功能及血流能量损耗（EL）。方法 对45例持续性AF（CAF组）、30例阵发性心房纤颤（PAF组）患者及41例健康志愿者（对照组）测量左心房常规结构及功能参数，采用2DTT技术获取左心房收缩期峰值应变及应变率（SLAs、SRLAs）、左心房舒张早期峰值应变及应变率（SLAed、SRLAed）、左心房舒张晚期峰值应变及应变率（SLAac、SRLAac）；以VFM技术测量心室收缩期和舒张期左心房整体能量损耗（EL-S、EL-D）；比较3组间各参数差异，分析不同时相EL与左心房结构及功能参数的相关性。结果 ①CAF组SLAs、SRLAs和PAF组各时相左心房应变及应变率均低于对照组（P均<0.05）；且CAF组SLAs、SRLAs低于PAF组（P均<0.01）；②CAF组和PAF组EL-S、EL-D均低于对照组（P均<0.01）；③各组EL-S与左心房整体排空分数（LATEF）、SLAs、SRLAs均呈正相关（r=0.26、0.33、0.19，P均<0.05），与左心房前后径（LAD）、左心房最大容积指数（LAVImax）、左心房最小容积指数（LAVImin）均呈负相关（r=-0.34、-0.25、-0.29，P均<0.01）；EL-D与LATEF、SLAs、SRLAs均呈正相关（r=0.30、0.38、0.25；P均<0.01），与LAD、LAVImax、LAVImin均呈负相关（r=-0.46、-0.36、-0.37，P均<0.01）。结论 各型AF均可致左心房心肌功能及血流能量受损。VFM联合2DTT技术能定量评估不同类型AF患者左心房心肌功能及血流能量损耗。 |
| 英文摘要: |
| Objective To assess left atrial myocardial function and blood flow energy loss (EL) in patients with different types of atrial fibrillation (AF) using vector flow mapping (VFM) combined with two-dimensional tissue tracking (2DTT). Methods Routine structural and functional parameters of left atrium of 45 patients with continuous AF (CAF group), 30 patients with paroxysmal AF (PAF group) and 41 healthy volunteers (control group) were measured. The left atrial systolic peak strain (SLAs) and left atrial systolic peak strain rate (SRLAs), left atrial early diastolic peak strain (SLAed) and left atrial early diastolic peak strain rate (SRLAed), left atrial late diastolic peak strain (SLAac) and left atrial late diastolic peak strain rate (SRLAac) were derived from 2DTT images, while the total EL of left atrium, including systolic EL (EL-S) and diastolic EL (EL-D) were acquired from VFM images. All parameters were compared among 3 groups, and the correlations of EL and left atrial structural and functional parameters were analyzed. Results ① SLAs and SRLAs in CAF group and all strain and strain rate parameters in PAF group were lower than those in control group (all P<0.05). SLAs and SRLAs in CAF group were lower than those in PAF group (both P<0.01). ②EL-S and EL-D in CAF and PAF group were lower than those in control group (all P<0.01). ③EL-S was positively correlated with the left atrial total emptying fraction (LATEF), SLAs and SRLAs (r=0.26, 0.33, 0.19; all P<0.05), EL-S was negatively correlated with the left atrial anteroposterior diameter (LAD), left atrial maximum volume index (LAVImax) and left atrial minimum volume index (LAVImin) (r=-0.34, -0.25, -0.29; all P<0.01). In addition, EL-D was positively correlated with the LATEF, SLAs and SRLAs (r=0.30, 0.38, 0.25; all P<0.01); EL-D was negatively correlated with LAD, LAVImax and LAVImin (r=-0.46, -0.36, -0.37; all P<0.01). Conclusion All types of AF could damage the left atrial myocardial function and increase the cost of blood flow EL. VFM combined with 2DTT can be used to simultaneously and quantitatively evaluate left atrial myocardial function and EL in patients with different types of AF. |
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