先天性心脏病患者的左心房涡流及其与左心房功能的关系

Keita Ito, Hideharu Oka, Yuki Shibagaki, Yuki Sasaki, Rina Imanishi, Sorachi Shimada, Yuki Akiho, Kazunori Fukao, Sadahiro Nakagawa, Kunihiro Iwata, Kouichi Nakau, Satoru Takahashi
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引用次数: 0

摘要

四维血流磁共振成像(MRI)可实现血流可视化。左心房涡流(LAVF)的缺失与血栓形成和心律失常的发生有关。然而,这一现象在先天性心脏病(CHD)患者中的临床意义仍不明确。本研究旨在揭示 LAVF 与先天性心脏病患者左心房功能的关系。研究纳入了 25 名接受心脏磁共振成像检查的参与者(8 名先天性心脏病术后患者,年龄为 17-41 岁;17 名志愿者,年龄为 21-31 岁)。所有参与者均为窦性心律。四维血流磁共振成像(速度编码为 100 厘米/秒)评估了 LAVF 的存在,并探讨了其与经胸超声心动图确定的左心房功能之间的关系。有 16 名患者检测出 LAVF。根据是否存在 LAVF 对参与者进行分类,LAVF 组 94% 的参与者为志愿者,而无 LAVF 组 78% 的参与者为术后患者。无 LAVF 参与者的左心房射血分数(61% 对 70%,P = 0.019)、储血室(32% 对 47%,P = 0.006)和导管(22% 对 36%,P = 0.002)功能明显低于有 LAVF 的参与者。LAVF 发生在心室收缩晚期,左心房储库功能可能是导致其发生的原因之一。许多患有先天性心脏病的术后患者都会出现左心房缺血。LAVF可能预示着左房重塑导致的早期左房功能障碍。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Left atrial vortex flow and its relationship with left atrial functions in patients with congenital heart disease
Four-dimensional flow magnetic resonance imaging (MRI) enables blood flow visualization. The absence of left atrial vortex flow (LAVF) has been implicated in the development of thrombus formation and arrhythmias. However, the clinical relevance of this phenomenon in patients with congenital heart disease (CHD) remains unclear. This study aimed to unravel the relationship of LAVF with left atrial functions in patients with CHD. Twenty-five participants who underwent cardiac MRI examinations were included (8 postoperative patients with CHD aged 17–41 years and 17 volunteers aged 21–31 years). All participants were in sinus rhythm. Four-dimensional flow MRI (velocity encoding 100 cm/s) assessed the presence of LAVF, and its relationship with left atrial function determined by transthoracic echocardiography was explored. LAVF was detected in 16 patients. Upon classification of the participants based on the presence or absence of LAVF, 94% of participants in the LAVF group were volunteers, while 78% of those in the without LAVF group were postoperative patients. Participants without LAVF had a significantly lower left atrial ejection fraction (61% vs. 70%, p = 0.019), reservoir (32% vs. 47%, p = 0.006), and conduit (22% vs. 36%, p = 0.002) function than those with LAVF. LAVF occurred during the late phase of ventricular systole, and left atrial reservoir function may have contributed to its occurrence. Many postoperative patients with CHD experienced a loss of LAVF. LAVF may indicate early left atrial dysfunction resulting from left atrial remodeling.
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