| 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纤颤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): |
| 超声血流向量成像联合二维组织追踪技术评价心房纤颤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 patients with atrial fibrillation using ultrasonic vector flow mapping combined with two-dimensional tissue tracking |
| 投稿时间：2019-09-16 修订日期：2020-05-18 |
| DOI： |
| 中文关键词: 心房纤颤 左心房 血流向量成像 二维组织追踪显像 心肌功能 能量损耗 |
| 英文关键词:atrial fibrillation left atrial vector flow mapping two-dimensional tissue tracking myocardial function energy loss |
| 基金项目:国家自然科学基金(81671852) |
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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纤颤（Af）患者左心房心肌功能及血流能量损耗特征。 方法 本研究共纳入45例持续性心房纤颤患者（CAf组）、30例阵发性心房纤颤患者（PAf组）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技术获取心室收缩期、舒张早期和心房收缩期左心房峰值应变和应变率（SLAs、SRLAs、SLAed、SRLAed、SLAac、SRLAac）；采用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）；比较三组间上述各观测参数的差异，同时分析不同时相EL与左心房结构及功能参数间的相关性。 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<0.05）；且CAf组SLAs、SRLAs低于PAf组(P<0.01)。②各房颤组EL-S、EL-D低于对照组（P<0.01）；CAf组EL-S、EL-D低于PAf组，但差异无统计学意义（P>0.05）。③所有研究对象EL-S与左心房整体排空分数（LATEF）、SLAS、SRLAS（r=0.26，0.33，0.19；均P<0.05）呈正相关，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）（r=-0.34，-0.25, -0.29；均P<0.01）呈负相关。EL-D与LATEF、SLAs、SRLAs（r=0.30，0.38， 0.25；均P<0.01）呈正相关，与LAD 、LAVImax、LAVImin (r= -0.46， -0.36，-0.37；均P<0.01)呈负相关。 结论 各种类型的Af均可导致左心房心肌功能及血流能量受损。VFM联合2DTT技术能够定量评估不同类型Af患者左心房心肌功能及血流能量损耗，为系统性同步观察Af患者左心房流固力学提供了一种新的方法。 |
| 英文摘要: |
| Objective To assess left atrial myocardial function and energy loss (EL) in patients with different types of atrial fibrillation (Af) using vector flow mapping (VFM) combined two-dimensional tissue tracking (2DTT). Methods Totally 45 patients with continuous atrial fibrillation (CAf group), 30 patients with paroxysmal atrial fibrillation (PAf group) and 41 healthy volunteers (control group) were enrolled. The normal structural and functional parameters of left atrium were measured. The left atrial systolic peak strain (SLAs), early diastolic peak strain (SLAed), late diastolic peak strain (SLAac), left atrial systolic strian rate (SRLAs), early diastolic strain rate (SRLAed) and late diastolic strain rate (SRLAac) were derived from the 2DTT images. The total energy loss of left atrium, including systolic energy loss (EL-S) and diastolic energy loss (EL-D) were acquired from VFM images. All the parameters were compared among the three groups for difference, and the correlations between EL and left atrial structural and functional parameters were analyzed. Results ① The SLAs and SRLAs in CAf group and all strain and strain rate parameters in PAf group were lower than those in control group (P<0.05). Additionally, the SLAs and SRLAs in CAf group were lower than those in PAf group (P<0.01). ②The EL-S and EL-D in both atrial fibrillation groups were lower than those in control group (P<0.01), the EL-S and EL-D in CAf group were lower than those in PAf group, but there was no significant difference (P>0.05). ③The EL-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); the 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, the EL-D was positively correlated with the LATEF, SLAs and SRLAs (r=0.30, 0.38, 0.25; all P<0.01); the EL-D was negatively correlated with the 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 energy. The techniques of VFM combined with 2DTT could be used to evaluate left atrial myocardial function and EL in patients with different types of Af simultaneously and quantitatively as a new method for systematic observation of left atrial flow field and mechanics in patients with Af. |
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