| PART I Evaluation of Flow Structure within Left Ventricle in Patients with Dilated Cardiomyopathy by Vector Flow MappingObjects To evaluate left ventricular function in the way of intracavitary flow dynamics by noninvasive Vector Flow Mapping with echocardiography, to discuss its clinical usefulness.Methods26patients with dilated cardiomyopathy(DCM) and44healthy controls were involved. The velocity distribution imagines on the section plane of the flow in the left ventricle were obtained by Vector Flow Mapping (VFM), and series parameters of velocity and distance were measured with the software named DSA-RS1. Including systolic parameters, such as velocity gradient from cardiac apex to the aortic valve (△Vs), distance from cardiac apex to the aortic valve (Ds), velocity according to half distance (Vs1/2), and diastolie parameters, such as velocity gradient from the mitral orifice to the apex (△Vd), distance from mitral orifice to cardiac apex (Dd), velocity according to half distance (Vd1/2). Results Compared with the values in the control group, parameters of systolic velocity (△Vs, Vs1/2) and parameters of diastolie velocity (△Vd, Vd1/2) were significantly lower, parameter of systolic distance ((Ds) and parameter of diastolie distance ((Dd) were significantly longer(P<0.05). Ds。 Dd were positive correlated with EDV, ESV, LV diameter (r>0.4, P<0.01), and negtively correlated with EF(r>0.3, P<0.01). Vsi/2。 Vd1/2were negtively correlated with EDV, ESV,LV diameter (r>0.3, P<0.01), and positive correlated with EF(r>0.3, P<0.01).Conclusion The velocity and acceleration of DCM group were lower than that of control group, VFM is a new noninvasive and clinically useful parameter for the evaluation of intracavitary flow dynamics.PART II Evaluation of Vortex within Left Ventricle in Patients with Dilated Cardiomyopathy by Vector Flow MappingObjects To evaluate left ventricular function in the way of intracavitary vortex by Vector Flow Mapping with echocardiography, and to demonstrate the formation and variation of the vortex.Methods26patients with dilated cardiomyopathy and44heathy controls were involved. The velocity distribution imagines on the section plane of the flow in the left ventricular were obtained by Vector Flow Mapping program berried in Aloka α10with a3.5-5.0MHz wide frequence probe, the location of the vortex and its variation in every phase of cardiac cycle were focused, and series parameters were measured, such as the diameter of the vortex (transverse diameter, vertical diameter), number of the vertex, the difference of the parameters within two groups were compared.Results①Vortex in normal control group:1.location:No vortex was observed during reduced ejection(d) period and isovolumic relaxation(e) period. Vortices were observed mostly during diastole period, nearby the anterior leaflet of mitral valve, middle upper1/3of left ventricle, and their shapes changed2～3times.2. Size and numbers: The diameters of the vortex (transverse diameter, vertical diameter), numbers of the vertices in one cardiac cycle during7phases were significantly different(P<0.01).②Vortex in DCM group:1.location:Vortices were observed in all7phases, mostly nearby the cardiac apex, middle lower2/3of left ventricle, and their shapes changed4～5times.2. Size and numbers:Compared with control group, the diameters of the vortex (transverse diameter, vertical diameter) during7phases in DCM group were bigger, and numbers of the vertices were larger (P<0.01). The diameters of the vortex (transverse diameter, vertical diameter), number of the vertices within DCM group in one cardiac cycle during7phases were significantly different(P<0.01).Conclusion Vortex in DCM group were significantly bigger than those of control group. Vetcor Flow Mapping could evaluate the pathophysiological change of DCM in way of demonstrating the variation of intracavitary votex.PART Ⅲ Vector Flow Mapping Evaluation of Regional Left Ventricular Flow Structure in Patients with Myocardial InfarctionObjects To evaluate blood flow structure within left ventricle, quantify the variation of the flow at infarct segments to assess the impact of myocardial infarction.Methods28patients with old myocardial infarction (OMI) and30healthy controls were involved. The flow vector images on the section plane of the flow within the left ventricle were acquired by Vector Flow Mapping (VFM). Time-flow (T-F) curve and all other peak systolic and diastolic flow curve include normal velocity profile, parallel velocity profile, vector profile were analyzed by DSA-RS1program.Results Ventricular ejction peak S, rapid ventricular filling peak E and atrial systole peak A were relatively lower in OMI group at infarct segment than normal control group, the time duration from bottom to peak was relatively longer in OMI group (p<0.05). Normal velocity profile, parallel velocity profile, vector profile, Flow profile at peak S and E were lower in OMI group than normal group (p<0.05).Conclusion The velocity of OMI group was lower and the time to peak was longer than that of control group. VFM is a new noninvasive and clinically useful parameter for the evaluation of regional left ventricle segmental function in way of demonstrating flow dynamics.PART IV Evaluation of Regional Cardiac Function in Patients with Old Myocardial Infarction in way of Demonstrating the Variation of Vortex within Left VentricleObjects To evaluate the variation of vortex within left ventricle, quantify the variation of the vortex at infaret segments to assess the impact of myocardial infarction.Methods29patients with old myocardial infarction (OMI) and30healthy controls were involved. The flow vector images on the section plane of the flow within the left ventricle were acquired by Vector Flow Mapping (VFM). Analyzed vortex at apex long-axis view and apex4-chamber view by DSA-RS1program, compare the numbers, locations, sizes, speeds of the vortex in two groups.Results①Numbers:Vortices were oobserved mostly during cardiac phases, no votex were observed during isvolumic relaxation period in both groups, Compare with normal control, vortex in OMI group are larger in numbers (p<0.05).②ocation:Votices were appeared at the middle-lower and apical infarct segment, the longitudinal distance from votex to Mitral valve were longer than normal group, the transversal distance from votex to central left ventricle were longer, votice were always appeared the infarct segment (p<0.05).③Size:The size of the vortice were bigger in OMI group in different views (p<0.05).④Velocity:Velocity in OMI group is lower than normal group, but no significant statistical difference. Conclusion VFM is an useful techinique to evaluate vortex of the left ventricle, vortex in OMI group is located nearby the infarct segment, larger in numbers, bigger in sizes, lower in speed. |
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