Study On Hemodynamics Of Ventricular Aneurysm With Myocardial Infarction By Vector Flow Mapping

Objectives: The changes of left ventricular energy loss(EL)and apical wall shear stress(WSS)in patients with ventricular aneurysm were observed by using vector flow mapping(VFM)technology,to explore the hemodynamic mechanism of thrombus formation in patients with ventricular aneurysm.Methods: Twenty seven patients with ventricular aneurysm due to anterior wall myocardial infarction were collected by conventional transthoracic echocardiography.Among them,16 patients were in the simple ventricular aneurysm group,11 patients were in the ventricular aneurysm with thrombus group,and 20 healthy people were collected as the normal control group to obtain the parameters of conventional echocardiography,The standard four chamber,three chamber and two chamber color blood flow dynamic images were taken,and the EL and WSS parameters of left ventricular segments in systole and diastole were measured by VFM analysis software.Resluts: 1.EL data comparison results During diastolic and systolic periods,there was no significant difference in EL of left ventricular apex segment between the aneurysm group and the thrombus group(P > 0.05),But they were lower than the normal control group,The difference was statistically significant(P < 0.05 or P <0.01).There was no significant difference in EL between the two groups(P > 0.05)in the basal and middle segments of the left ventricle.2.WSS data comparison results During diastole,There was no significant difference in WSS between the aneurysm group and the thrombus group(P > 0.05),But the peak WSS of septal apical,lateral apical and anterior apical segments in the aneurysm group and the aneurysm thrombus group were lower than that in the control group,and there was statistical difference(P < 0.05 or P < 0.01),The mean WSS of the anterior wall apical segment in the aneurysm group were lower than those in the control group,the difference was statisticall y significant(P < 0.01).During systole,the peak WSS of the anterior wall apical segment in the aneurysm group and the aneurysm thrombus group was lower than that of the control group,the mean WSS of the anterior wall apical segment of the aneurysm group was lower than that in the control group(P < 0.05).WSS in the anterior apical segment of patients in the aneurysm thrombus group was higher or higher than that in patients with aneurysm group,and the difference of mean WSS between the two groups was statistically significant(P < 0.05).There was no significant difference in the other data between the two groups.Conclusions: VFM can be used to evaluate the energy loss and wall shear stress of the left ventricle in patients with aneurysm,and provide a new perspective for further understanding the intracardiac hemodynamics in patients with aneurysm or without thrombus.