血流向量成像技术评估心房颤动患者窦性心律下左心室能量损耗

目的 采用血流向量成像技术（VFM）定量评估心房颤动（AF）患者窦性心律下左心室血流能量损耗（EL）。方法 对54例AF患者（AF组）及29名健康志愿者（对照组）行VFM检查,分析等容收缩期（T1）、收缩早期（T2）、收缩晚期（T3）、舒张早期（T4）和心房收缩期（T5）左心室基底段、中间段和心尖段EL,比较2组一般资料、心功能参数以及EL的差异。以与对照组相比5个时相均有统计学意义的EL为应变量、一般资料和心功能参数为自变量,采用多元逐步回归分析各时相EL增高的危险因素。结果 AF组体表面积、左心室舒张末期容积（LVEDV）、左心室收缩末期容积（LVESV）、左心房最大容积指数（LAVI_max）、二尖瓣舒张早期血流峰值（E）/心房收缩期血流峰值（A）及E/二尖瓣环运动速度（e''）均高于对照组,而A和e''低于对照组（P均<0.05）。各时相基底段EL及T4中间段、心尖段EL,T1、T2心尖段EL明显增高（P均<0.05）;其他时相各节段差异均无统计学意义（P均>0.05）。各时相基底段EL增高的危险因素分别为T1：年龄、E/A;T2：LVESV;T3：LVESV;T4：E/A、E、e'';T5：A、年龄。结论 AF可致左心室各时相基底段EL增高;采用VFM技术定量评估AF患者左心室EL,为观察AF对左心室血流模式的影响提供了新的思路。     

彩色多普勒超声评价超重人群心脏结构、功能及颈动脉内-中膜厚度

目的 应用彩色多普勒超声检查观察超重对心脏结构、功能及颈动脉内-中膜厚度(IMT)的影响。方法 根据体质量指数(BMI)将100名体检者分为正常对照组(BMI<25 kg/m²,47名)和超重组(BMI≥25 kg/m²,53名)。对两组均行彩色多普勒超声心动图及颈动脉超声检查,分析超重对心脏结构、功能及颈动脉IMT的影响。结果 与正常对照组相比,超重组左心室舒张末期内径(LVDD)、左心室舒张末期室间隔厚度(IVST)、左心室后壁舒张末期厚度(LVPWT)、左心室质量(LVM)、左心室质量指数(LVMI)、二尖瓣舒张晚期峰值血流速度(A峰)、颈动脉IMT增高,二尖瓣舒张早期峰值血流速度(E峰)和E／A降低,差异均有统计学意义(P均<0.05)。BMI与LVDD、IVST、LVPWT、LVM、LVMI、A峰、颈动脉IMT均呈显著正相关(P均<0.05),与E/A、E峰均呈负相关(P均<0.01)。结论 超声检查发现无任何临床症状的超重人群可发生左心室增大、舒张功能减退以及颈动脉IMT。     

应用VFM技术评价扩张型心肌病收缩期左心室心腔内血流动力学变化

目的 探讨血流向量成像(VFM)技术在评价扩张型心肌病(DCM)收缩期左心室心腔内血流动力学变化及收缩功能变化中的应用价值。方法 病例组:DCM患者30例;对照组:健康志愿者40名。在VFM成像模式下测量并比较两组收缩期峰值流速(Vs)、峰值流量(Fs)和收缩期负向总流量(SQ-);应用Simpson双平面法获取左心室射血分数(LVEF),与三腔心的Vs、Fs、SQ-均值进行相关性分析;同时观察并描述病例组收缩期左心室心腔内涡流的分布特征。结果 病例组基底段、中间段及心尖段Vs、Fs、SQ-均值明显低于对照组(P＜0.01);两组组内比较各项指标均由基底段至心尖段逐渐递减(P＜0.05);LVEF与Vs、Fs、SQ-均值呈明显正相关,相关系数分别为0.727、0.698、0.709(P＜0.01);病例组在收缩期3个时相均有涡流出现,直径及圈数较对照组增多。结论 VFM技术可直观、定量评价DCM患 者左心室内血流流场变化,进而显示其与左心室收缩功能的关系,有望成为临床检测DCM左心室收缩功能的一种新方法。     

血流向量图——评估房间隔缺损分流量的新方法

目的 应用超声血流向量图(VFM)技术,分析房间隔缺损的分流量及其影响因素。方法 选取20例Ⅱ孔型房间隔缺损患者为观察对象,应用VFM技术获得心腔内的血流速度向量和流线图,采用DSA-RS1软件测量房间隔缺损最大径处的分流量,分析分流量与肺循环血流量与体循环血流量的比值(Q_p/Q_s)、房间隔缺损最大直径、左、右心房的压力及差值的相关性。结果 通过VFM获得的房间隔缺损分流量与Q_p/Q_s呈正相关(r=0.93,P＜0.01)。分流量受房间隔缺损大小影响最大(r=0.95, P<0.05),即房间隔缺损越大,分流量越大。房间隔缺损分流量越大,左心房的收缩压越低(r=－0.61, P<0.05)、左、右心房间收缩压的压力差越小(r=－0.57, P<0.05)。房间隔缺损的分流量与右心房收缩压、左、右心房间的舒张压差和平均压差均无相关性(P均>0.05)。结论 VFM能够真实地反映心腔内血流动力学的变化。应用VFM技术可直接测量房间隔缺损的分流量,为临床提供有价值的血流动力学参数。     

实时心肌造影评价犬腺苷预适应的心肌保护作用

目的 探讨腺苷预适应对犬心肌缺血再灌注后收缩功能及危险区心肌血流量的保护作用。 方法 健康犬13只,随机分为2组:腺苷预适应组(n=7):缺血前静脉滴注腺苷0.3 mg/min,30 ml;对照组(n=6):缺血前静脉滴注生理盐水30 ml作为平衡对照。阻断左冠状动脉前降支,制作心肌缺血再灌注模型(缺血3 h,再灌注1 h),于阻断前基础状态、缺血3 h、再灌注1 h各时间点经股静脉注入造影剂声诺维,分别采集左心室乳头肌水平短轴图像。同步记录左心室压力曲线。 结果 腺苷预适应组再灌注1 h的左心室内压峰值(LVSP)高于对照组(P＜0.05);缺血3 h、再灌注1 h的左心室内压最大上升速率高于对照组(P均＜0.05);心肌缺血再灌注后,坏死区、危险区心肌血流量低于正常区,其中坏死区最低(P均＜0.05),腺苷预适应组危险区心肌血流量较对照组增加(P＜0.05)。 结论 腺苷预适应能够有效改善犬心肌缺血再灌注后收缩功能,增加危险区心肌血流灌注,改善心肌微循环。     

三维斑点追踪技术评价冠状动脉狭窄患者左心室局部和整体收缩功能

目的 探讨三维斑点追踪成像(3D-STI)技术早期检测冠状动脉狭窄患者左心室局部和整体收缩功能的价值.方法 收集46例冠状动脉狭窄(冠状动脉狭窄组)和33例可疑冠状动脉狭窄患者(对照组),经胸采集左心室全容积三维动态图像,测量左心室舒张末期容积(LVEDV)、左心室收缩末期容积(LVESV)、心输出量(CO)、每搏量(SV)、左心室舒张末期质量(LVEDMass)、左心室收缩末期质量(LVESMass)、左心室射血分数(LVEF)及整体长轴应变(GPSL),获得左心室17个心肌节段的节段性面积应变值(AS)及整体面积应变均值(GAS);比较两组间及缺血和非缺血心肌节段上述指标差异,对GAS和LVEF进行相关性分析.结果 剔除图像不清晰病例,最终冠状动脉狭窄组41例,对照组30例.冠状动脉狭窄组GPSL和GAS均低于对照组 (P均<0.05).冠状动脉狭窄组缺血心肌节段AS较非缺血心肌节段和对照组心肌节段均明显减低(P均<0.01),冠状动脉狭窄组非缺血心肌节段和对照组心肌节段AS差异无统计学意义(P>0.05).GAS与LVEF呈负相关(r=-0.720,P<0.01).结论 3D-STI可通过测量不同心肌节段面积应变早期评价冠状动脉狭窄患者心肌收缩功能的变化.     

定量组织速度成像技术评价绝经女性心肌运动速度和心脏功能

目的 通过定量组织速度成像(QTVI)技术评价绝经女性心肌运动速度和心脏功能的变化及其意义。方法 随机选取绝经期女性188例,包括围绝经期组90例,绝经早期组98例;行常规超声心动图检测后,存储QTVI模式图像,将取样点置于左心室各壁二尖瓣环附着点及三尖瓣环右侧位点,测量心肌运动速度及时相参数,计算心肌收缩期功能指数(SMPI)及Tei指数,并进行统计学分析。结果 与围绝经期组相比,绝经早期组左心室质量、相对室壁厚度二尖瓣口舒张早期峰值流速(E峰)/二尖瓣口舒张晚期峰值流速(A峰)和舒张早期峰值运动速度(Ve)/舒张晚期峰值运动速度(Va)均显著减低(P均<0.01),左心室等容舒张时间延长(P<0.05),左心室射血时间缩短(P<0.01),SMPI增高(P<0.05),Tei指数增高(P均<0.05)。结论 与围绝经期相比,绝经早期女性心肌运动速度及心脏功能减低,可能与女性体内性激素水平在绝经前后的变化有关;QTVI能够提供多种量化数据,对女性健康保健有重要指导意义。     

二维斑点追踪技术评价急性心肌梗死患者经皮冠状动脉介入治疗后冠状动脉侧支循环对左心室功能的影响

目的 采用二维斑点追踪成像(STE)技术评价急性心肌梗死(AMI)患者经皮冠状动脉介入治疗(PCI)后冠状动脉侧支循环(CCC)对左心室功能的影响。方法 选择接受急诊PCI的AMI患者51例,根据冠状动脉造影结果将患者分为有侧支循环组(CCC组)和无侧支循环组(N-CCC组)。再根据冠状动脉闭塞情况及室壁运动评分将患者左心室18节段心肌分为正常心肌组、缺血心肌组和梗死心肌组。患者分别在PCI术后72 h及1个月接受超声检查,检测并比较左心室心肌整体收缩、舒张功能及心肌纵向应变(LS)和应变率(LSR)。结果 与术后72 h比较,1个月时CCC组和N-CCC组缺血及梗死心肌的LS均增大(P<0.01)。术后72 h,CCC组缺血心肌LSR-s大于N-CCC组(P<0.05)。术后1个月,CCC组缺血及梗死心肌LS均大于N-CCC组(P<0.05),且恶性心律失常发生率低于N-CCC组(P<0.05)。结论 CCC可显著改善AMI患者PCI术后72 h缺血心肌和术后1个月缺血、梗死心肌的收缩功能及左心室整体舒张功能。     

实时三维超声心动图定量评价原发性高血压患者右心室舒张功能

目的 探讨实时三维超声心动图(RT-3DE)定量评价原发性高血压(PH)患者右心室舒张功能的价值。方法 收集51例PH患者和51名健康志愿者(对照组),根据左心室质量指数将PH患者分为非左心室肥厚(NLVH)组和左心室肥厚(LVH)组。采用多普勒超声测量三尖瓣口舒张早期峰值血流速度(E)、舒张晚期峰值血流速度(A)、三尖瓣前瓣环处舒张早期心肌运动速度(Ea)、舒张晚期心肌运动速度(Aa),计算E/A、Ea/Aa和E/Ea;应用RT-3DE时间-容积曲线,计算右心室舒张期充盈1/4、1/3、1/2、3/4容积的时间比率(D_1/4、D_1/3、D_1/2、D_3/4),计算1/3充盈分数(1/3 FF)、峰值充盈率(PFR)。比较组间上述参数差异,分析PH患者上述参数间的相关性。结果 NLVH组16例、LVH组35例,其E/A、Ea/Aa均小于对照组(P均<0.05);NLVH组Ea、E/Ea与对照组比较差异均无统计学意义(P均>0.05),而LVH组Ea小于对照组、E/Ea大于对照组(P均<0.05);NLVH和LVH组D_1/4、D_1/3、D_1/2和D_3/4均高于对照组(P均<0.05),PFR和1/3 FF均低于对照组(P均<0.05);NLVH和LVH组上述参数差异均无统计学意义(P均>0.05)。PH患者D_1/4、D_1/3、D_1/2和D_3/4与E/Ea呈正相关,PFR、1/3 FF与E/Ea呈负相关(P均<0.05)。结论 应用RT-3DE能直接获得右心室容积随时间变化的相关参数,对评价PH患者右心室舒张功能有重要指导意义。     

组织多普勒速度成像定量测量瓣环运动速度评价缩窄性心包炎患者术后心功能改变

目的 应用组织多普勒技术定量评价缩窄性心包炎(CP)患者手术治疗后心脏收缩、舒张功能改变。 方法 选取已确诊为CP且择期接受CP心包剥脱术的患者22例,于手术前及术后1个月分别行超声检查,存储心尖四腔心、心尖两腔心及心尖部左心室长轴切面组织多普勒二维图像,以定量组织多普勒技术分析并记录二尖瓣环各部位及三尖瓣环侧壁收缩期及舒张期峰值运动速度(S'、E'),分别计算各个节段S'、E'及三尖瓣环的平均速度作为二尖瓣环的总体运动速度。 结果 CP患者术后1个月左心室变大(P<0.001),左心房(P=0.011)及右心房(P=0.004)呈不同程度缩小,左心室射血分数增高(P=0.021);三尖瓣环、二尖瓣环左心室侧壁及室间隔S'、E'均有不同程度减低(P均<0.05),三尖瓣环、二尖瓣环S'、E'峰亦有不同程度减低(P均<0.01)。 结论 CP患者术后左心室射血分数增加,心脏各腔室发生趋于正常的重构;术后短期内切除心包瓣环部位S'及E'较术前减低,表明左心室壁纵向运动速度减低。     

Intuitive visualization and quantification of intraventricular convection in acute ischemic left ventricular failure during early diastole using color Doppler-based echocardiographic vector flow mapping

The aim of this study was to make an intuitive visualization of intraventricular convection (IC) and quantification of intraventricular convection velocity (ICV) in acute ischemic left ventricular (LV) failure of open-chest canines during early diastole contrast to the baseline conditions using color Doppler-based echocardiographic vector flow mapping (VFM). The animal care committee approved this prospective study. In 6 anesthetized open-chest beagle models, the emergence time and the emergence sites of IC in the LV cavity during early diastole were visualized at the standard apical 3-chamber (AP3c) views with the VFM at baseline conditions and after coronary artery ligation. The global ICV and the ICV at the basal, middle and apical levels of LV at the AP3c views at T1, T2, T3, T4, and T5 between both states were compared respectively (T1: the beginning of LV rapid filling period; T2: the middle of LV rapid filling period; T3: the peak of LV rapid filling period; T4: the middle of period of reduced filling; T5: the end of early diastole.). Acute ischemic LV failure with a marked increase in LV end diastolic volume and LV minimal diastolic pressure was induced by coronary artery ligation. The IC appeared only during the period of reduced filling at baseline conditions, and limited to the basal level of LV cavity. But the IC appeared throughout all the early diastole, and was seen almost occupying whole LV cavity during ischemia. The peak of the global ICV for both states appeared at T4. The global ICV at the AP3c views in acute ischemic failure LV cavity increased than those of baseline conditions at the T1 (6.593 ± 0.834 cm(2)/s vs. 0.000 ± 0.000 cm(2)/s, P < 0.001), T2 (9.457 ± 0.852 cm(2)/s vs. 0.000 ± 0.000 cm(2)/s, P < 0.001), T3 (14.765 ± 1.791 cm(2)/s vs. 2.030 ± 0.502 cm(2)/s, P < 0.001), T4 (25.392 ± 4.640 cm(2)/s vs. 6.688 ± 1.343 cm(2)/s, P < 0.001), and T5 (15.890 ± 3.159 cm(2)/s vs. 2.518 ± 0.869 cm(2)/s, P < 0.001). And the ICV at the basal, middle and apical levels at AP3c views in acute ischemic failure LV cavity also increased than those of baseline conditions at the same phase of early diastole (P < 0.01), except for the ICV at the LV basal level at T1. VFM is a powerful tool for visualization IC and quantification of ICV on profiles of LV flow fields, which can give intriguing insights into the subtle, flow-associated LV fluid dynamics of normal and abnormal cardiac function. It will be of great practical importance to elucidate the accurate physiological and the pathophysiological significance of the IC in further studies, so as to determine whether the cardiac function can be precisely evaluated with IC related index, and to incorporate VFM into clinical routine practice in the future.     

血流向量成像定量评价急性心肌梗死患者等容收缩期左心室涡流

目的应用血流向量成像(VFM)技术分析急性心肌梗死(AMI)患者等容收缩期左心室内血液流场的特点。方法选择AMI患者25例和正常志愿者40名,采集两组心尖三腔心切面彩色血流动态图像,应用VFM分析软件测量等容收缩期左心室内涡流横径、纵径,涡流的横向、纵向相对位置及其最大向量速度、涡流强度等指标,比较上述两组各参数。结果与正常志愿者比较,AMI患者等容收缩期涡流纵径增大(P<0.05),横向位置更靠近后侧壁,最大向量速度、涡流强度均减低(P<0.05)。结论等容收缩期AMI患者左心室内涡流纵径、横向位置、最大向量速度、涡流强度与正常人相比存在差异,涡流形态、位置发生改变。VFM为评价心腔内血液流场特征提供了新的途径。     

血流向量成像定量评价正常婴幼儿心腔血流动力学

目的应用血流向量成像(VFM)技术定量观察正常婴幼儿心室腔内血流动力学变化。方法选取0.6～36.0个月的健康婴幼儿40名,中位月龄9.5个月。以VFM分别定量心尖四腔的左、右心室峰值血流速度在心腔内分布的位置,血流量峰值时间和每个心动周期正、反向累计血流量及心腔内涡流的数量、位置、出现时间和涡流量。结果左、右心室腔内舒张期峰值血流速度均位于心腔正中,而收缩期峰值血流速度均位于心腔内偏室间隔侧。心腔内的血流速度及血流量均自基底段向心尖段逐次递减,但同一心腔内各节段的血流量的达峰时间差异无统计学意义(P>0.05);心室内涡流多持续在等容收缩期;与右心室腔相比,左心室腔内涡流面积及涡流量均明显增高(P<0.05)。左心室腔内涡流量与体表面积、心肌质量呈正相关(P<0.05),与心率呈负相关(P<0.05)。结论 VFM技术能定量评价和可视化显示婴幼儿心腔内血流动力学的变化,可用于评价儿童心脏疾病。     

Left ventricular energy loss and wall shear stress assessed by vector flow mapping in patients with hypertrophic cardiomyopathy

The aim of this study was to assess left ventricular (LV) summation of energy loss (EL-SUM), average energy loss (EL-AVE) and wall shear stress (WSS) using vector flow mapping (VFM) in patients with hypertrophic cardiomyopathy (HCM). Forty HCM patients, and 40 controls were evaluated by transthoracic echocardiography. Conventional echocardiographic parameters, summation and average of energy loss (EL-total, EL-base, EL-mid and EL-apex), and WSS in each segment were calculated at different phases. Compared with controls, conventional diastolic measurements were impaired in HCM patients. HCM patients also showed increased EL-SUM-total and EL-AVE-total at the peak of LV rapid ejection period as well as decreased EL-SUM-total and EL-AVE-total at the end of early diastole. In controls, EL-SUM and EL-AVE showed a gradual decrease from the basal segment to the apex, this regularity was not observed in HCM patients. Compared with controls, HCM patients showed increased WSS at the peak of the LV rapid ejection period and the atrial contraction period as well as decreased WSS at the end of early diastole (all p?<?0.05). WSS was increased slightly at the peak of the LV rapid filling period in HCM patients (p?=?0.055). EL and WSS values derived from VFM are novel flow dynamic parameters that can effectively evaluate systolic and diastolic hemodynamic function in HCM patients.     

斑点追踪成像评价冠心病患者左心室舒张期形变及解旋运动

目的 观察应用斑点追踪成像(STI)技术评价冠心病患者左心室舒张期形变及解旋运动的价值.方法 随机选择临床拟诊为冠心病患者117例,根据冠状动脉造影或冠状动脉CTA结果分成心肌梗死组(60例)、心肌缺血组(31例)及对照组(26例).常规测量二尖瓣口舒张期血流速度(E、A)及二尖瓣后瓣环的运动速度(E'、A'),计算E/E'.运用STI技术测量左心室舒张期各方向应变率、解旋率.结果 与心肌缺血组、对照组相比,心肌梗死组E/E'增大,纵向、径向、圆周方向舒张早期及晚期应变率、解旋率减低(P＜0.001);与对照组比较,心肌缺血组仅解旋率、舒张早期纵向应变率、舒张早期与晚期圆周方向应变率减低,差异均有统计学意义(P均＜0.05).结论 STI技术能有效评价冠心病患者左心室舒张期各方向的形变及解旋运动;与常规超声参数相比较,左心室舒张期径向、圆周方向应变率及解旋率能更早地反映心肌缺血患者左心室舒张功能的减低.     

血流向量图分析正常左心室等容收缩期血流动力学特点

目的 应用血流向量图(vector flow mapping,VFM)技术分析正常左室等容收缩期是否为血流动力学停滞期.方法 健康志愿者50例,心尖左室长轴观记录动态彩色多普勒血流图像,VFM技术分析等容收缩期左室内血流动力学特点.结果 舒张末期左室腔内形成一个较大的整体涡流,并持续至整个等容收缩期,于射血早、中期消失.它使左室腔内原本朝向心尖的血流于心尖部转向,向基底部流出道流动.结论 等容收缩期并非左室的血流动力学停滞期,在这一时相,心脏依靠涡流完成了血液的传递和血流的转向,更实现了血流动量的传递.     

Dissipative energy loss within the left ventricle detected by vector flow mapping in diabetic patients with controlled and uncontrolled blood glucose levels

Diabetes mellitus (DM) is related to increased risks of cardiovascular diseases, such as myocardial infarction, diabetic cardiomyopathy and secondary hypertension. Dissipative energy loss (EL) derived from vector flow mapping (VFM) is thought to reflect the efficiency of blood flow and has been deemed to be an index for the evaluation of left ventricular function. Our study aimed to investigate the value of dissipative EL in diabetic patients with controlled and uncontrolled blood glucose by VFM. Eighty-eight patients with DM and 58 age-matched healthy controls were recruited. All of the patients received echocardiography examinations. VFM analyses were executed to calculate the EL values according to the apical four-chamber examinations from the left ventricle (LV) view. Our results showed that diastolic EL was compromised in the controlled-blood glucose (59.19 mV/m vs. 32.68 mV/m, p?=?0.039) patients and was more dramatically increased in the uncontrolled blood glucose group (88.84 mV/m vs. 32.68 mV/m, p?<?0.001) compared with the healthy controls. The impairment of systolic EL was observed only in the uncontrolled blood glucose patients (39.65 mV/m vs. 20.29 mV/m, p?<?0.001) and not in the controlled blood glucose patients (29.25 mV/m vs. 20.29 mV/m, p?=?0.072). Multivariate backward stepwise linear regression analysis revealed that the HbA1c level was independently related to the diastolic EL (β?=?0.233, p?=?0.026) and systolic EL (β?=?0.237, p?=?0.023). VFM is feasible and reproducible for assessing LV dissipative EL in DM patients with normal LVEF values in whom diastolic EL may be a more vulnerable indicator of early LV cardiac dysfunction in patients with DM. However, LV systolic EL may be a sensitive indicator of preclinical LV dysfunction for patients with DM with uncontrolled blood glucose levels. Uncontrolled blood glucose, which is independently correlated with subclinical LV dysfunction, may lead to increases in systolic EL and diastolic EL in LV.     

2型糖尿病患者脑血流和功能连接变化及与记忆功能的关系

目的 纵向观察2型糖尿病(T2DM)患者脑血流量(CBF)及功能连接(FC)变化,分析CBF、FC与记忆功能的关系.方法 对27例T2DM患者(T2DM组)及36名健康志愿者(对照组)行头部MR检查及记忆功能测评,并于5年后随访复查.对CBF行重复测量方差分析,以CBF改变存在显著组别×时间交互效应的脑区作为种子点行F...     

Prolonged vortex formation during the ejection period in the left ventricle with low ejection fraction: a study by vector flow mapping

Purpose

Vortex formation in the left ventricle (LV) can be visualized by novel vector flow mapping (VFM) based on color Doppler and speckle tracking data. The aim of this study was to evaluate the impact of a vortex during the ejection period using VFM.

Subjects and methods

Color Doppler images were obtained to produce VFM images in 80 subjects (20 normal, 29 with dilated cardiomyopathy, and 31 with old myocardial infarction). The duration of the LV vortex was measured and expressed as the ratio to the ejection time (VTRe).

Results

The VTRe showed significant correlations with EDV (ρ = 0.672, p < 0.001), ESV (ρ = 0.772, p < 0.001), EF (ρ = ?0.783, p < 0.001), left atrium diameter (LAd) (ρ = 0.302, p = 0.007), stroke volume (ρ = ?0.600, p < 0.001), e′ (ρ = ?0.389, p < 0.001), a′ (ρ = ?0.314, p = 0.005), s′ (ρ = ?0.512, p < 0.001), and E/e′ (ρ = 0.330, p = 0.003). The diastolic parameters (e′, a′, E/e′, LAd) were not correlated when they were adjusted by EF.

Conclusions

In the normal LV, a vortex existed for only a limited time during the early ejection period. In contrast, the lower the EF was, the longer the vortex remained during systole. Evaluation of vortices by VFM may noninvasively provide novel insights into the pathophysiology of impaired cardiac function.