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Objective:To observe the change of the left ventricular(LV) wall shear stress (WSS) using vector flow mapping (VFM) in different segments at each phase of diastolic period among normal subjects.Methods:From August 2018 to March 2019, 200 healthy volunteers selected from the Physical Examination Center of the Second Affiliated Hospital of Harbin Medical University were recruited. The WSS values of LV segments at the same and at different phases[isovolumic relaxation period(D1), rapid filling period(D2), slow filling period(D3), atrial contraction period(D4)] in diastole were measured and analyzed.Results:①The relationships of the WSS of LV different segments at the same phase of diastolic period: The WSS values of anterior septum, posterior septum and posterior wall during D1, and the WSS values of posterior septum, posterior wall and inferior wall during D2 showed basal>middle>apical segments, the differences were statistically significant (all P<0.05). ②The changes of the WSS values of LV different segments during diastolic period: During D1-D2-D3-D4 period, the absolute values of WSS in anterior septum, posterior septum, anterior wall, lateral wall and inferior wall showed an increasing-decreasing-increasing trend. During D2-D3-D4 period, the absolute values of WSS in the posterior wall showed a decreasing-increasing trend. During D1-D2-D3-D4 period, the absolute values of WSS in the apical segment of anterior septum, basal and middle segments of posterior septum, basal, middle and apical segments of anterior wall, basal segment of lateral wall, the middle and apical segments of posterior wall, basal and middle segments of inferior wall all showed an increasing-decreasing-increasing trend, the difference was statistically significant (all P<0.05). Conclusions:The LV WSS in different segments at the same phase or in the same segment at the different phases in diastole exhibit a regular change and is consistent with the LV hemodynamic changes, which indicates that WSS can quantitatively reflect the hemodynamic changes of the LV in normal subjects.
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Objective To quantify the left ventricular flow field characteristics of different phases of cardiac cycle in patients with different degrees of coronary artery stenosis by using vector flow mapping ( VFM ),and explore the value of quantitative parameters of VFM in diagnosis of degrees of coronary artery stenosis in patients with coronary heart disease. Methods Eighty-four patients with coronary artery stenosis showed by coronary angiography served as case group. According to the results of coronary angiography,all the patients of case group were divided into 3 groups:mild stenosis group,moderate stenosis group and severe stenosis group. Forty-five healthy adult volunteers were selected as control group. The quantitative parameters,including average energy loss ( EL-base,EL-mid,EL-apex ) and circulation ( vortex area,circulation),were measured in the different periods of VFM mode. The difference of parameters were evaluated between case group and control group during different periods. E/e′was derived via dual-Doppler imaging technology and correlation was analyzed between aEL, circulation, E/e′( L ) and E/e′( S ), separately. ROC curve was used to analyze aEL in severe stenosis group,and to evaluate the diagnostic efficacy of aEL in different cardiac cycles. Results ①Compared with the control group,aEL in global and regional segment of left ventricle in the severe stenosis group were significantly increased during isovolumetric relaxation period,reduced filling period,atrial systolic phase and isovolumic contraction period ( all P ＜ 0.05 ). And the aEL in global and regional segment of left ventricular in the moderate stenosis group were significantly increased during reduced filling period, atrial systolic phase and isovolumic contraction period ( all P ＜0.05). And the aEL in middle segment of left ventricular in the mild stenosis group was significantly increased during reduced filling period ( P ＜0.05). ②Compared with the control group, the vortex area and circulation intensity in left ventricular of the severe stenosis grrculation intensity and E/e′( L) or E/e′( S) during reduced filling period and atrial systolic phase . Conclusions VFM can effectively evaluate the flow field characteristics of left ventricle in patients with oup were significantly increased during isovolumetric relaxation period,reduced filling period,atrial systolic phase and isovolumic contraction period( P ＜0.05). ③ In case group,there were positive correlations between aEL withE/e′(L) orE/e′(S) at global and regional segment of rapid filling phase and atrial systolic phase . And there were positive correlations between the vortex area orcoronary heart disease . The quantitative parameters of VFM can reflect the extent of coronary artery stenosis in some extent.
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Objective@#To observe the hemodynamic change characteristics of left ventricle and evaluate left ventricular systolic function in patients with chronic heart failure (CHF) via vector flow mapping(VFM).@*Methods@#Sixty-two patients with CHF(CHF group) were selected as case group and were divided into three groups (B, C, D) according to the American College of Cardiology Foundation and the American Heart Association (ACC/AHA ) recommended stages.Sixty healthy volunteers were selected as control group. The left ventricular circulation parameters (vortex quantity, vortex area, circulation) and energy loss (EL) of the apex, mid, and basal segments in different groups were compared in all the systolic phases. Left ventricular ejection fraction (LVEF) was calculated by biplane Simpson method, and the correlation was analyzed with the parameters of circulation and EL.@*Results@#①In the phase of isovolumetric contraction (IVC) and slow ejection (SE), compared with the control group, the levels of EL were increased in mid and basal segments (P<0.01 or P<0.05) in CHF group. The vortex area and circulation during IVC and rapid ejection (RE) were higher in CHF group than those in the control group (P<0.01 or P<0.05). As for SE, only vortex quantity was higher in CHF group than that in the control group (P<0.05). ②In CHF group, EL were increased at stage B and stage C than those in the control group (P<0.05), and EL were decreased at stage D than those in the control group ( P<0.05). Meanwhile, there was decreased tendency of EL in CHF group with the increase of ACC/AHA stages. ③The circulation during IVC of phase D was higher in CHF group than that in the control group (P<0.05), the vortex area during RE was greater in CHF group than that of the control group and stage B (P<0.05). ④EL was positively correlated with LVEF at basal segment of IVC(r=0.615, P<0.001). The vortex area during RE, circulation during IVC and RE were negtively correlated with LVEF (r=-0.598, -0.594, -0.623; all P<0.001).@*Conclusions@#VFM technology can quantify the left ventricular hemodynamic changes of patients with CHF in the systolic phase, and shows its relationship with left ventricular systolic function, to provide objective basis for grading of CHF and also provide objective quantitative indicators for clinical treatment and curative effect evaluation.
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Objective To understand the blood pressure level of the aged in longevous area of Yunnan Province. Methods According to the forth census information,typical multistaged sample-survey was used for 15 counties (cities) with centenarians over 1/100 000 and the 3 counties (cities) with centenarians under 1/100 000. The blood pressure of people aged 60 and over were measured and the investigation questionnaire was filled in. Results The overall level of the blood pressure was systolic pressure (130.8?24.6) mm Hg and diastolic pressure (81.7?14.6) mm Hg. The systolic pressure increased in slow slope with the age growing, ranged 126.2-137.6 mm Hg, and higher in male than in female. The diastolic pressure was not affected by age growing. The difference of blood pressure in nationality was mainly affected by the latitude and the elevation. Conclusions With the age increasing, the blood pressure level of the aged people gradually increases.
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Objective To investigate on out the deformity in the elderly of longevous area and the characteristics of the regions in Yunnan Province. Methods According to the forth census information, using multistage sample typical survey to the 18 counties (cities) with centenarians over 1/100 000. The deformity types of people aged 60 and over and the deformity rate of various age groups and its distribution were investigated. Results Among the 6 477 people aged 60 and over investigated, a total of 1 928 people were in deformity, the deformity rate was 29 8%. The elder the people, the higher the deformity rate was. The highest deformity rate was in Kunming and Chuxiong prefectures. The audition deformity was highest among all types of deformity in elder people. The occurrence of fracture was highest in Miao Nation in Honghe prefecture, reaching 18.1%. About 14 % of the centenarian people sufferred from dementia. Conclusions Effective control in blood pressure and osteoporosis are important method to protect the elder people and to promote the level of quality of life of the elderly.