应用血流向量成像评价AMI患者PCI术前术后左室涡流变化特占

目的：应用血流向量成像（VFM）技术评价急性心肌梗死（AMI）患者经皮冠状动脉介入术（PCI）术前、术后左心室收缩期涡流状态变化。方法：选择健康检查者25例（正常对照组）和AMI患者30例（AMI组），分别对健康检查者和AMI患者PCI术前、术后1个月行超声心动图检查，采集连续三个心动周期标准三切面彩色血流动态图，分析左心室收缩期涡流横径、纵径、横向、纵向位置及最大向量速度，比较涡流在正常对照组、AMI组术前、术后的变化并进行统计学分析。结果：与正常对照组相比，AMI组术前左心室收缩早期涡流纵径增大[分别为（27．08±4．37）和（21．64±5．41）min，P〈0．05]，最大向量速度减小[分别为（25．23±8．42）和（32．83±12．23）cm／s，P〈0．05]。术后1个月AMI组涡流流量、强度、最大向量速度较术前增加（P〈0．05）。结论：健康成人左心室收缩期涡流遵循一定的规律，AMI患者左室收缩期涡流不规则，导致能量的损耗，PCI术后患者的涡流状态有所改善。VFM技术为评价急性心肌梗死患者及PCI术前、术后心腔内血流变化提供了一种新途径。

Evaluation of vortex in left ventricle during systolic phase in patients with acute myocardial infarction by vector flow mapping before and after PCI

Objective：To evaluate the characteristics of vortex in the left ventricle （LV） of patients, who suffered from acute myocardial infarction （AMI）,before and after PCI by using vector flow mapping （VFM）. Methods：Thirty patients with acute myocardial infarction were examined by two-dimensional echocardiography before and after PCI and twen- ty-five healthy people were examined as well. The apical three-chamber color Doppler images in three sequent cardiac cycles were collected and the parameters of the left ventricular systolic vortex including vortex width, length, transverse, depth po- sition, maximum vector speed were analyzed by VFM, and the differences o{ vortex were compared between the normal group and patients with acute myocardial infarction before and after PCI. Results：In the early systolic stage, longitudinal diameter was longer in patients with acute myocardial infarction than that of healthy persons （27.08 ±4.37 vs 21.64±5.41, P〈0.05） ,vortex maximum speed was reduced （25.23± 8.42 vs 32.83 ±12.23, P〈0.05）, the vortex flow and strength were reduced, vortex maximum speed was increased after PCI （P〈 0.05）. Conclusion： There are some regularities of the vortex which are followed in the healthy persons and those in the patients with acute myocardial infarction are irregular, which would make the energy loss. In this study, the results suggest that the parameters of vortex are ameliorated after PCI, which provide a new approach to estimate hemodynamic change of the heart before and after PCI for further research.