| 摘要: |
| 目的 应用血流向量成像（VFM）技术分析心功能正常乙肝肝硬化患者的左心室压力差值（intraventricular pressure differences，IVPDs）与左心室压力梯度（intraventricular pressure gradients, IVPGs）并评价其临床价值。 方法 选取2022年4月至2022年10月在哈尔滨医科大学附属第一医院临床诊断为乙肝肝硬化但心功能正常（符合2020版超声心动图临床应用指南正常标准）的患者39例，另选取正常对照组31例。应用VFM技术分别计算左心室等容收缩期（IC）、快速射血期(RE)、等容舒张期(IR)、快速充盈期(RF)、缓慢充盈期(SF)和心房收缩期(AC)的IVPDs、IVPGs，同时采集常规心脏超声指标，并比较两组受试者上述各项指标的差异。 结果 ①乙肝肝硬化组AC-IVPD、AC-IVPG均高于正常对照组(P <0.05)；②乙肝肝硬化组AC-IVPD和AC-IVPG相关性与A峰呈正相关(r=0.608、0.581，均P <0.001)，与平均E/e'呈正相关(r=0.495、0.433，均P <0.01)，与E/A呈负相关(r=-0.535、-0.605，均P <0.001)，与e'室间隔呈负相关（r=-0.412、-0.500，均P <0.01），与e'左室侧壁呈负相关（r=-0.374、-0.410，均P <0.01）。 结论 VFM技术可以从血流动力学角度发现乙肝肝硬化患者左室舒张期压力梯度变化，从而为进一步研究乙肝肝硬化患者的早期心脏功能尤其是为舒张功能的改变提供新的视角。 |
| 关键词: 血流向量成像 左室舒张功能 乙肝肝硬化 相对压成像 |
| DOI： |
| 投稿时间：2023-03-22修订日期：2023-04-21 |
| 基金项目: |
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| Evaluation of left ventricular pressure by vector flow mapping in patients with hepatitis B liver cirrhosis |
| Zhou Kang,Lu Tianqi,Bi Shiyu,Jiang Jian,Yang Xiuhua,Zhang Wei |
| (Department of Ultrasound，Qunli Hospital，the First Affiliated Hospital of Harbin Medical University) |
| Abstract: |
| Objective To analyze the left intraventricular pressure differences（LVPDs） and left intraventricular pressure gradients（IVPGs） in patients with hepatitis B cirrhosis with normal cardiac function and to evaluate their clinical value by applying the blood flow vector imaging (VFM) technique. Methods Thirty-nine patients clinically diagnosed with hepatitis B cirrhosis but with normal cardiac function (meets the normal criteria of the 2020 edition of the clinical application guidelines for echocardiography) at the First Hospital of Harbin Medical University from April 2022 to October 2022 were selected and another 31 normal controls were selected. The VFM technique was applied to calculate the IVPDs and IVPGs of left ventricular isovolumic systole (IC), rapid ejection phase (RE), isovolumic diastole (IR), rapid filling phase (RF), slow filling phase (SF) and atrial systole (AC), respectively, while the conventional cardiac ultrasound indices were collected, and the differences of the above indices between the two groups of subjects were compared. Results ①AC-IVPD and AC-IVPG were higher in the cirrhotic group than in the standard control group (P < 0.05); ②AC-IVPD and AC-IVPG correlations in the cirrhotic group were positively correlated with the A peak (r = 0.608, 0.581, both P < 0.001), with the mean E/e' (r = 0.495, 0.433, both P < 0.01), negative correlation with E/A (r=-0.535, -0.605, both P < 0.001), negative correlation with e' septum (r=-0.412, -0.500, both P < 0.01), and negative correlation with e' left ventricular sidewall (r=-0.374, -0.410, both P < 0.01). Conclusions The VFM technique can detect changes in the left ventricular diastolic pressure gradient from a hemodynamic perspective in patients with hepatitis B cirrhosis, thus providing a new perspective to further study the early cardiac function, especially the altered diastolic function, in patients with hepatitis B cirrhosis. |
| Key words: Vector flow mapping Left ventricular diastolic function Hepatitis B cirrhosis Relative pressure imaging |
