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Objective:To evaluate the distribution of diastolic left ventricular pressure in patients with type 2 diabetes mellitus (T2DM) by relative pressure imaging (RPI) based on vector flow mapping (VFM), and to explore the clinical risk factors for the diastolic left ventricular pressure distribution.Methods:Thirty patients with T2DM and thirty normal controls were included from August 2020 to July 2021 in Fuwai Central China Cardiovascular Hospital. All selected subjects underwent conventional echocardiography.Left intraventricular pressure difference (IVPD) and left intraventricular pressure gradient (IVPG) were measured using RPI of VFM in isovolumic relaxation (IR), rapid filling (RF), atrial contraction (AC), isovolumic contraction (IC) and rapid ejection (RE) phases. The relationships between IVPD with other parameters were analyzed.Results:①Compared with the control group, E/A, e′, IVPD-IR, IVPG-IR, IVPD-RF, IVPG-RF, IVPD-AC, and IVPG-AC were significantly lower and E/e′ was significantly greater in the T2DM group ( P<0.05). ②IVPD-IR, IVPD-RF, and IVPD-AC were positively correlated with E/A ( r=0.309, P<0.05; r=0.274, P<0.05; r=0.273, P<0.05). IVPD-IR, IVPD-RF, and IVPD-AC were negatively correlated with E/e′ ( r=-0.587, P<0.05; r=-0.273, P<0.05; r=-0.415, P<0.05). IVPD-IR and IVPD-AC were positively correlated with e′ ( r=0.451, P<0.05; r=0.431, P<0.05). ③Multivariable linear regression analysis showed that hemoglobin A 1c (HbA 1c) was an independent risk factor affecting IVPD-IR, IVPD-RF, and IVPD-AC (β=-0.417, P<0.05; β=-0.451, P<0.05; β=-0.460, P<0.05). Conclusions:RPI of VFM can quantitatively evaluate diastolic left ventricular pressure distribution in patients with T2DM. HbA 1c is an independent risk factor affecting IVPD-IR, IVPD-RF, and IVPD-AC.
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Objective:To analyze the changes of energy loss(EL) in systemic lupus erythematosus(SLE) patients and the relationship between EL and cardiac function by vector flow mapping(VFM).Methods:The intraventricular hemodynamics of 60 females with SLE(SLE group) and 61 healthy female controls(control group) who attended the First Affiliated Hospital of Nanjing Medical University from August 2015 to August 2019 were compared, and cardiac function changes were evaluated using VFM. The EL at each segment of the left ventricular chamber (total, basal, middle, and apical segments) during each period of the cardiac cycle (isovolumic contraction, rapid ejection, rapid filling, reduced filling, atrial contraction) were analyzed. Relationship between EL and clinical and echocardiographic parameters was analyzed.Results:In SLE group, EL decreased from basal to middle to apical segments, with significant difference (all P<0.01). Compared with the control group, EL in early, middle, late diastole and rapid ejection period in SLE group was significantly increased (all P<0.01). During the rapid filling period, the EL was positively correlated with septal E′ ( r=0.784, P<0.001), and during the atrial contraction period EL was positively correlated with septal E/e′ ( r=0.812, P<0.001) and A ( r=0.715, P<0.001). During isovolumic contraction period, EL was positively correlated with interval E/e′, peak A ( r=0.461, 0.672; all P<0.001). Conclusions:VFM of patients with SLE can comprehensively, rapidly, and efficiently evaluate changes of myocardial mechanics and intracardiac hemodynamics, and provide quantitative analysis of complex intracardiac blood flow.
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Objective:To investigate the changes of intraventricular pressure differences (IVPDs) and intraventricular pressure gradients (IVPGs) in different diastolic phases of hypertensive patients with different left ventricular configurations by relative pressure imaging (RPI) based on vector flow mapping (VFM), and to explore its diagnostic value for diastolic function in hypertensive patients with different left ventricular configurations.Methods:Totally 180 patients with hypertension were selected from April 2020 to March 2021 in the Outpatient Clinic of the Second Affiliated Hospital of Harbin Medical University. According to the relative wall thickness (RWT) and left ventricular mass index (LVMI), the patients were divided into normal geometry group (NG group, n=62), concentric remodeling group (CR group, n=62) and concentric hypertrophy group (CH group, n=56). Sixty-one healthy volunteers were selected as the control group. Clinical data and echocardiographic parameters were collected and the differences of each parameter among 4 groups were compared. IVPDs and IVPGs in four diastolic phases were obtained by RPI, including isovolumic relaxation (IR), rapid filling (RF), slow filling (SF) and atrial contraction (AC). The differences of IVPDs and IVPGs in each phase of diastole among 4 groups and their correlations with echocardiographic parameters were analyzed, and the diagnostic efficacy of RPI parameters in NG group patients with reduced diastolic function was analyzed by the ROC curve. Results:The absolute values of IVPDs and IVPGs were greater in all subgroups of hypertension than those of the control group at each diastole phase( P<0.001). Pairwise comparisons showed statistically significant differences of IVPDs-IR and IVPGs-IR among 4 groups( P<0.001). They were correlated with E/e′( rs=-0.615, -0.605; all P<0.001). IVPDs-IR and IVPGs-IR had good diagnostic efficacy for the decrease of diastolic function of patients in NG group, the cutoff values were <-0.705 mmHg (AUC=0.935, P<0.001) and <-0.130 mmHg/cm (AUC=0.926, P<0.001). Conclusions:RPI can precisely assess different degrees of diastolic function changes in hypertensive patients with different configurations. IVPDs-IR and IVPGs-IR can be used as potential new indicators for non-invasive early diagnosis of hypertensive patients with reduced diastolic function, which is of great significance for timely clinical intervention and treatment of reversing ventricular remodeling.
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This study aims to explore the intraventricular pressure difference (IVPD) within left ventricle in patients with paroxysmal atrial fibrillation (PAF) by using the relative pressure imaging (RPI) of vector flow mapping (VFM). Twenty patients with paroxysmal atrial fibrillation (PAF) and thirty control subjects were enrolled in the study. Systolic and diastolic IVPD derived from VFM within left ventricle and conventional echocardiographic parameters were analyzed. It was found that the B-A IVPD of left ventricle in PAF patients showed the same pattern as controls-single peak and single valley during systole and double peaks and double valleys during diastole. Basal IVPD was the main component of base to apex IVPD (B-A IVPD). The isovolumetric systolic IVPD was associated with early systolic IVPD, early systolic IVPD was associated with late systolic IVPD, and late systolic IVPD was associated with isovolumic diastolic IVPD (all
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Humans , Atrial Fibrillation/diagnostic imaging , Diastole , Heart Ventricles , Ventricular Function, Left , Ventricular PressureABSTRACT
Objective:To quantitatively evaluate the energy loss (EL) and vortex characteristics in the left ventricle by vector flow mapping (VFM) technique in heart failure patients with mid-range ejection fraction (HFmrEF) and reduced ejection fraction (HFrEF).Methods:One hundred and five patients in Qilu Hospital of Shandong University from October 2016 to November 2017 with heart failure and left ventricular ejection fraction (LVEF)<50% were enrolled and divided into HFmrEF Group (LVEF40%~<50%, 56 cases) and HFrEF group (LVEF<40%, 49 cases). Another 32 healthy people at the same period were matched as control group. The EL, vortex area and circulation of isovolumic relaxation phase (IVR), rapid filling phase (RFP), atrial contraction phase (ACP), isovolumic contraction phase (IVC) and rapid ejection phase (REP) in the left ventricle was measured by VFM technique.Results:The EL in HFmrEF group and HFrEF group was lower than that in the control group. In ACP, the EL was gradually decreased among the control group, HFmrEF group and HFrEF group( P<0.05). In ACP, the vortex area and circulation was larger in heart failure patients than those in the control group, and gradually increased from control group, to HFrEF group( P<0.05). Positive correlation between EL and E/e ′ was evidenced in the RFP ( r=0.524, P< 0.001). While in ACP, there was a positive correlation between EL and A peak ( r=0.492, P<0.001), and a negative correlation between EL and vortex area ( r=-0.235, P=0.040). Conclusions:VFM can be applied to evaluate the EL in left ventricle. The EL in the left ventricle of patients with HFmrEF and HFrEF is significantly lower than that in control group. El is correlated with cardiac systolic and diastolic function and vortex area.
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Objective:To evaluate the characteristics of diastolic left intraventricular pressure differences(IVPD) and intraventricular pressure gradients(IVPG) among normal adults in different ages by vector flow mapping.Methods:From March 2019 to October 2020, 1 093 healthy volunteers were selected from the physical examination center of the Second Affiliated Hospital of Harbin Medical University, and they were divided into youth group (18-40 years old), middle-aged group (41-65 years old) and elderly group (>65 years old). IVPD and IVPG during isovolumetric relaxation(IR) period, rapid filling (RF) period, slow filling(SF) period, and atrial contraction(AC) period were measured by vector flow mapping, and were correlated with left ventricular diastolic function parameters.Results:①IVPD-IR, IVPD-AC, IVPG-IR, and IVPG-AC gradually increased while IVPD-RF, IVPD-SF, and IVPG-RF gradually decreased from the youth group to the elderly group(all P<0.05). ②IVPD-RF and IVPG-RF were positively correlated with E( r=0.391, 0.402, P<0.001, respectively). IVPD-AC and IVPG-AC were positively correlated with A( r=0.407, 0.425, P<0.001, respectively) and E/e′( r=0.268, 0.294, P<0.001, respectively) while negatively correlated with E/A( r=-0.510, -0.506, P<0.001, respectively) and e′/a′( r=-0.514, -0.511, P<0.001, respectively). Conclusions:IVPD and IVPG can quantitatively analyze the changes of left ventricular hemodynamics in normal subjects, which are expected to be new indexes to evaluate left ventricular diastolic function.
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Objective To quantitatively analyze the changes in left ventricular mean energy loss ( EL ) using blood flow vector imaging ( VFM ) in patients with aortic stenosis retained by ejection fraction . Methods T hirty‐five subjects were selected as the control group ,and 71 patients with aortic stenosis were chosen as the case group ,including mild aortic stenosis ( miAS) group( 23 cases) ,moderate aortic stenosis ( moAS) group( 23 cases) ,and severe arterial stenosis ( seAS) group( 25 cases) . Left atrial anteroposterior diameter ( LAA ) ,left ventricular end‐diastolic diameter ( LVEDD ) ,left ventricular end‐diastolic volume ( LVEDV ) ,left ventricular end‐systolic volume ( LVESV ) ,left ventricular ejection fraction ( LVEF ) and E/A were measured by conventional echocardiography . T he average total EL ( EL‐T ) , average basal segment EL ( EL‐B) ,average middle segment EL ( EL‐M ) and average apical segment EL ( EL‐A ) of each isovolumic contraction phase ( IVC ) and rapid ejection phase ( RE ) were measured by VFM ,and the differences in mean EL among each groups were compared . Results Compared with those in the control group ,average EL‐B ,average EL‐M and average EL‐T in each case group of the left ventricle during IVC and RE were increased ,the average EL‐A in seAS group of the left ventricle during IVC were increased ,and the differences were statistically significant( all P ＜0 .05) . Compared with those in miAS group ,the average EL‐B ,average EL‐M and average EL‐T in seAS group of the left ventricle during IVC and RE were increased ,and the differences were statistically significant ( all P ＜ 0 .05 ) . Compared with those in miAS group ,the average EL‐A in moAS group and seAS group of the left ventricle during RE were increased ,and the differences were statistically significant ( all P ＜ 0 .05 ) . Conclusions VFM technology can directly reflect the hemodynamic changes in the left ventricular chamber of patients with aortic stenosis retained by ejection fraction ,and provide a new method for the evaluation of left ventricular systolic function in patients with aortic stenosis .
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Objective To assess left ventricular diastolic function by vector flow mapping ( VFM ) in patients with mitral valve plasty . Methods A total of 30 patients undergoing mitral valve plasty were enrolled . The dissipative energy loss ( EL) of basal ,middle ,apical and global left ventricular segments in rapid filing phase ,slow filling phase ,and atria contract period were measured by VFM ,and the EL above were compared in 1 week preoperatively ,1 week and 1 month postoperatively . Results Compared with 1 week preoperatively ,EL in all diastole in basal and middle left ventricular segments were significantly increased at 1 week after operation (all P <0 .05) ,EL in some diastole in apical and global left ventricular segments were significantly increased at 1 week after operation ( all P <0 .05) ,and EL in all diastole in all left ventricular segments were significantly increased at 1 month after operation (all P <0 .05) . Compared with 1 week postoperatively ,EL in all diastole in all left ventricular segments were significantly increased at 1 month after operation ( all P < 0 .05) . Conclusions VFM can quantitatively evaluate left ventricular diastolic function ,and helps to evaluate treatment response at preoperative and postoperative .
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Objective To quantify the diastolic average energy loss ( EL) of left ventricle in patients with pregnancy-induced hypertension ( PIH ) by vector flow mapping ( VFM ) technique and explore the clinical significance of EL in evaluating left ventricular diastolic function in patients with PIH . Methods Fifty-seven cases of singletonic PIH in late pregnancy ( PIH group) and 38 cases of the third trimester normal singleton pregnancy (control group) were enrolled in this study . VFM were used to analyze the total average energy loss ( ELt) and average energy loss at the basal level ( ELb) ,the papillary muscle level ( ELp) ,and the apical level ( ELa) in isovolumic relaxation ,rapid filling ,mid-diastol and atrial systole phases ,and the differences between the two groups were compared . The correlation between ELt and E/e in both groups were analyzed . Results In PIH group ,ELt ,ELb ,ELp and ELa in the mid-diastolic and atrial systolic phases were significantly higher than those in control group ( all P < 0 .01 ) ;ELt ,ELp ,ELa in isovolumic diastolic phase and ELt ,ELb and ELa in fast filling phase were higher than those in control group ( all P < 0 .05) . There was a positive correlation between ELt and E/e in isovolumic diastolic phase ,rapid filling phase and atrial systolic phase in PIH group ( r = 0 .326 ,0 .386 ,0 .403 ;all P < 0 .05) . There was a positive correlation between the ELt of fast filling and atrial systolic phases and E/e in control group ( r =0 .498 ,0 .371 ;all P < 0 .05 ) . Conclusions Increased left ventricular diastolic flow EL in PIH patients reflects the abnormal intraventricular hemodynamic changes ,and it is related to left ventricular diastolic function parameters for the quantitatively evaluation of PIH patients ,and might be feasible to reveal the extent and mechanism of left ventricular diastolic dysfunction .
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Objective To quantitatively analyze the energy loss ( EL) of the left ventricle in dilated cardiomyopathy (DCM) by vector flow mapping (VFM). Methods Sixty-four DCM patients confirmed by clinical were enrolled and divided into three groups according to the level of left ventricular ejection fraction (LVEF):mild decreased LVEF group(group A,40% ≤ LVEF＜ 50% ),moderate decreased LVEF group ( group B,30% ≤LVEF＜40% ) and severe decreased LVEF group ( group C,LVEF＜30% ). Forty healthy volunteers were selected as control group ( group D,53% ≤ LVEF≤73% ) for physical examination. The images of apical four-chamber and three-chamber in color Doppler echocardiography were acquired and EL was analyzed in different phases in a cardiac cycle. Results There was no significant difference of the EL in isovolumic systole and isovolumic diastole between DCM groups and the control group ( P ＞ 0.05). In rapid and slow ejection period,the EL in group B and C were much lower than those in the control group ( P＜0.05). In rapid filling phase,the EL in DCM groups were much lower than that in the control group ( P＜0.05).While in slow filling period and atrial systole the EL in group C was lower than that in the control group ( P ＜0.05). Conclusions VFM provides a new perspective for the cardiac function study of DCM patients.
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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 evaluate the changes of left ventricular structure and cardiac function in patients after video-assisted thoracic pneumonectomy by ultrasonic vector flow mapping (VFM) and quantitatively evaluate the diagnostic value of left ventricular flow energy loss(EL) for pneumonectomy patients with impaired cardiac function.Methods Thirty-six pneumonectomy patients were selected as case group and 30 health cases as control group.The echocardiographic parameters were acquired and left ventricular volume,left atrial volume and parameters of left diastolic founction were routinely measured.The EL of the left ventricularat early diastole and late diastole under the VFM mode were acquired.Results ①Left ventricular volume and left atrial volume comparsion:there was no significant difference in left ventricular end diastolic volume(LVEDV),left ventricular end systolic volume (LVESV),left ventricular ejective fraction(LVEF),and left atrial end diastolic volume(LAVd) between the two groups (all P ＞ 0.05);left atrial end systolic volume(LAVs) and left atrial emptying volume(LAVe) in case group were mild lower than control group(P ＜0.05).②Comparsion of diastolic function parameters:E,A,E/e and HR of case group were significant higher than those in control group (all P ＜0.05),EDT and E/A ratio in case group were significant lower than those in control group (all P ＜ 0.05),there was no significant difference of IVRT between two groups (P ＞0.05).③Comparison of EL at early diastole:only ELTB and ELAM had mild difference between case group and control group (all P ＜0.05).④Comparison of EL at late diastolic:EL of entirety and each segment of left ventricle of case group increased (all P ＜ 0.05).Conclusions VFM can quantitatively evaluate the left ventricular flow characteristics after video assisted thoracic pneumonectomy,and the increase in EL may reflect the left ventricular diastolic dysfunction in patients after pneumonectomy.
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Objective To evaluate the value of left ventricular energy loss (EL) in the systolic left ventricular hemodynamic changes in hypertensive patients by ultrasonic flow vector imaging (VFM). Methods Ninty-eight hypertensive patients were divided into non left ventricular hypertrophy group (NLVH group) and left ventricular hypertrophy group (LVH group) according to the left ventricular mass index(LVMI).Thirty-one healthy adults were erolled as control group.The average total energy loss (EL-T),basal energy loss (EL-B),middle energy loss (EL-M) and apical energy loss (EL-A) of each isovolumic contraction phase,fast ejection phase and slow ejection phase were obtained by VFM,the difference among the three groups were compared.Results ①EL-T and EL-B in isovolumic phase,rapid ejection phase and slow ejection phase in NLVH group were higher than those in control group ( P <0.05 or P <0.01);EL-T,EL-B,EL-M and EL-A in isovolumic phase,rapid ejection phase and slow ejection phase in LVH group were all higher than those in control group ( P <0.05 or P <0.01);EL-M in isovolumic phase and rapid ejection phase,EL-T,EL-B,EL-M and EL-A in slow ejection phase in LVH group were higher than those in the NLVH group ( P <0.05 or P <0.01).② There was a positive correlation between EL-T and LVMI (r=0.311, P < 0.01),EL-B and LVMI ( r = 0.219, P < 0.05),EL-M and LVMI( r = 0.207, P <0.05),EL-T and LVEF( r = 0.340, P < 0.05),EL-B and LVEF( r = 0.367, P < 0.01) in isovolumic contraction phase.There was a positive correlation between EL-B and LVEF( r = 0.359, P < 0.01) in rapid ejection phase.There was a positive relation between EL-B and LVEF( r =0.352,P <0.05) in slow ejection phase.Conclusions The EL of systolic peroid in hypertensive patients increased,which suggests that the left ventricular hemodynamic changes abnormally,VFM can accurately evaluate the changes of hemodynamic during systole.
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Objective To study the characteristics of blood flow in isovolumic systole(IVC)of left ventric-ular(LV)in patients with dilated cardiomyopathy by flow-vector imaging(VFM). Methods Color flow Doppler imaging was performed from the apical long-axis view in 58 patients with dilated cardiomyopathy who was admitted in our hospital from October 2015 to November 2016 and 56 healthy volunteers as control. Doppler flow data ob-tained during IVC were analyzed offline with vector flow mapping.Results At the beginning of IVC,the swirl area (15 ± 3)cm2and flow(36 ± 8)cm2/s in the control group were significantly less than those in the observation group (27 ± 8)cm2,(45 ± 12)cm2/s,all P=0.000.At the end of IVC,the vortex flow was similar in both groups[(28 ± 4)cm2/s vs.(29 ± 11)cm2/s,P=0.617)],and the vortex area in the control group was significantly smaller than that in the observation group[(16 ± 3)cm2vs.(24 ± 9)cm2,P=0.000)].During the IVC,the area of the vortex in the control group increased slightly but not significantly(P = 0.073),but the flow rate decreased significantly (10 ± 27%). The area and volume of the vortex in the observation group decreased significantly with the flow de-creased by 29 ± 54%(P=0.000 vs.the control group).When the aortic valve was open,the average blood flow veloc-ity in the middle and basal parts of the LV compartment in the observation group was significantly lower than that in the control group(P<0.05).In multivariate models,a decreased LV ejection fraction was the only independent pre-dictor of the percentage decrease in area of the vortex during the IVC(P < 0.001),and a larger QRS width(P =0.026)and LV end-systolic long diameter(P = 0.004)were independent predictors of the percentage decrease in flow volume of the vortex. Conclusion The VFM technique enables a better assessment of the pathophysiological state of LV lumen energy loss during IVC in patients with dilated cardiomyopathy by vortex imaging.
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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 quantitatively analyze the energy loss (EL) in left ventricle with vector flow mapping (VFM) in hypertensive patients,and try to reveal the correlation of EL with cardiac structure and function.Methods Hypertension group:52 hypertensive individuals were enrolled in our study,divided into 4 subgroups:①14 patients with normal geometry(NG);②20 patients with concentric remodeling(CR);③15 patients with concentric hypertrophy(CH);④3 patients with eccentric hypertrophy(EH)(not enrolled in subgroup analysis).Health control group were composed of 32 healthy volunteers.LVEF,LVMI and E/e′ were measured.And the EL in left ventricle was measured at different phases and different segments based on VFM images.Results ①EL comparison:in the phrase of late diastole(DL),isovolumic contraction(IVC) and rapid ejection(RE),compared with the control group,EL in entirety and each segment of left ventricle in hypertension group increased (P0.05);②Correlation analysis:in the phrase of DL,IVC and RE,EL in entirety and each segment of left ventricle showed significant positive correlations with LVMI and with E/e′ (P<0.05).In the phrase of DL,EL in entirety and each segment of left ventricle showed significant negative correlations with LVEF(P<0.05).Conclusions EL measured quantitatively by VFM is more sensitive to reflect the changes of hemodynamic in hypertensive individuals.EL is closely correlated with cardiac structure and function.
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Objective To detect left atrial (LA) function and left ventricular (LV)-LA coupling using vector flow mapping (VFM) and two-dimensional tissue tracking (2DTT) echocardiography in patients with diabetes.Methods A total of 51 patients with type 2 diabetes (DM group) and 38 healthy volunteers (control group) were studied.LA and LV strain were assessed by 2DTT.The energy loss (EL) of LA and LV during ventricular systole (ELs),early diastole (ELed),and atrial contraction (ELac) were measured by VFM.Results LVEL in DM group was significantly increased compared to that in control group (P<0.05).LAELs and LAELed in control group were higher than those in DM group (P<0.05);while LAELac decreased in control group (P<0.05).Multivariate regression analysis identified E and LVELed as independent predictors of LAELed;Peak torsion,LA peak systolic strain and LVELac were independent predictors of LAELac.Conclusions The reservoir and conduit function of LA are impaired in patients with DM,while the pump function increases as a compensation.Abnormal LA-LV coupling also appears in patients with DM.
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Objective To investigate the left ventricular hemodynamic changes of patients with hypertension by echocardiography using vector flow mapping (VFM).Methods Twenty-eight patients with hypertension (hypertension group) and 26 normal subjects (control group) were involved.All the subjects underwent conventional transthoracic echocardiographic examination and VFM on apical 3 chambers view.The evolution of velocity distribution,stream line and vorticity line in left ventricle were observed.Left ventricle was divided into basal,mid and apical segments,in which vorticity parameter (Vmax) were quantitatively measured and analyzed.Its relations to conventional left ventricular parameters (E,A,E/A,EDT,E/e') were then analyzed.Results ①Compared with the control group,LV end-diastolic,end-systolic volumes and E/e' significantly increased.The evolution of velocity distribution,stream line and vorticity in the hypertension group was slightly irregular.② In mid-diastole phase,vorticity of the control group showed the trend (middle＞ base ＞ apex)(P ＜0.05),which wasn't shown in hypertension group.In other phases,vorticity of both groups decreased from base to apex (P ＜0.05).③There were statistically differences in vorticity between the two groups in early diastolic phase,late diastolic phase of apex and late systolic phase of middle (P =0.045,0.004,0.015,respectively).④ There were negative correlations between Vmax in late diastolic phase of every segment and E/A (from basal segment to apex:r =-0.310,-0.334,-0.333;P =0.028,0.020,0.021).There was positive correlation between Vmax in isovolumic contraction time and E/e' (r =0.348,P =0.016).Conclusions VFM can be utilized to analyze left ventricular hemodynamics quantitatively and it may be a good supplement for assessing cardiac diastolic function.
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Objective To investigate the changes of left ventricular(LV) vortex strength(VS) and distribution during selective cardiac pacing in a phases of cardiac cycle using vector flow mapping techniques ,and associate with LV mechanical performance ,so as to provide basic experimental database for optimizing the sites of the artificial cardiac pacing in clinic conditions .Methods Eight heathy open‐chest Beagle dog models were employed for selective right ventricular apical (RVAP ) ,left ventricular apical (LVAP) and lateral wall pacing (LVLP) .The standard two‐dimensional apical three views with color Doppler flow and dynamic two‐dimensional images were acquired consecutively in three cardiac cycles for further off‐line analysis ,conventional parameters were measured at same time .Results Compared with baseline ,LVSV ,LVEF ,LVCO and dp/dtmax were both reduced ,and the parameters obtained leftside cardiac pacing were lower than that of right ventricular pacing ( P < 0 0.5) ,there′s no significant difference in E/Vp .The vortex pattern ,distribution and vorticity at six typical phases induced by selective cardiac pacing were totally different from those at baseline with sinus rhythm ,and leftside pacing were worsen than RVAP ,the LVAP were most obvious .On multivariable regression analysis ,the VS during ES (VSES ) at baseline was independently related to late‐diastolic VS and longitudinal strain (R2 = 0 6.3 ,P < 0 0.01 and P=0 0.03 ,respectively) .Conclusions The selective cardiac pacing could induce intracardiac vortex changes and differ from that at baseline ,and the persistence of vortex from late diastole into ES is a haemodynamic measure of coupling between diastole and systole .
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PurposeTo explore the left ventricle flow propagation process in patients with chronic heart failure (CHF) using velocity flow mapping. Materials and Methods Patients with CHF (n=25) were selected as CHF group. Healthy subjects (n=28) were chosen as the control group. Flow reversal interval (FRI), flow reversal rate (FRR), corrected flow reversal rate (CFRI) and flow rate in peak ejection (FRPE) were measured. Parameters related to the vortex in CHF group were compared with that in the control group. Results Compared with the control group, FRI was longer [(71±13) msvs. (113±30) ms, P<0.05], FRR and FRPE were lower [(46.85±21.35) cm2/svs. (27.90±16.77) cm2/s;(74.54±9.10) cm2/svs. (41.12±17.25) cm2/s,P<0.05] in CHF group. FRI and CFRI were positively correlated with the Tei index (r=0.812 and 0.849,P<0.01). FRI was negatively correlated with LVEF, FS, SV, CO, CI (r=-0.646--0.515,P<0.05 orP<0.01). CFRI was negatively correlated with LVEF, FS, SV, CO and CI (r=-0.685--0.456,P<0.05 orP<0.01); FRR was negatively correlated with Tei index (r=-0.604,P<0.05), and was positively correlated with LVEF, FS, SV, CO and CI (r=0.503-0.812,P<0.05 orP<0.01);FRPE was negatively correlated with Tei index (r=-0.734,P<0.01), and were positively correlated with LVEF, FS, SV, CO and CI (r=0.557-0.776,P<0.05 orP<0.01).Conclusion Velocity flow mapping can demonstratecardiac hydromechanics in patients with chronic heart failure. The heart blood flow direction reversal efficiency may be a new method for diagnosis and treatment evaluation.