超多普勒测量主动脉瓣狭窄患者心内血流动力学的变化

J. Sabatino, I. Leo, A. Strangio, Sabrina La Bella, Rosalba De Sarro, Vincenzo Montemurro, G. Pedrizzetti, Fabio Troilo, Marco Maglione, Daniele Torella, Giovanni Di Salvo, Salvatore De Rosa
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引用次数: 0

摘要

由于开发了基于超声心动图的新测量方法,心内血流动力学评估近来变得越来越重要。最近的研究表明,心脏异常与心内涡流的变化有关。然而,之前还没有研究评估过主动脉瓣狭窄(AS)对心内涡流的影响。 该研究前瞻性地纳入了 120 名重度 AS 患者、60 名同心重塑患者(VR)和 100 名对照组患者(CTRL),并对他们进行了心内血流动力学的无创评估。除标准超声心动图外,还通过超多普勒对流体动力学进行了评估。 与CTRL相比,AS的涡流深度(p<0.001)、涡流长度(p=0.003)、涡流强度(p<0.001)和涡流面积(p=0.049)显著增加。此外,与 CTRL(p<0.001)和 VR(p=0.002)相比,AS 的平均能量耗散明显更高。在 ROC 分析中,AS 的涡流深度显示出最好的分辨能力(p<0.001)。 基于流体动力学的超多普勒指数的变化可对强直性脊柱炎患者进行可靠的评估。涡流深度和强度的显著变化可选择性地将强直性脊柱炎与同心重塑和健康对照组区分开来,这表明心内血流动力学评估可为标准超声心动图提供补充信息,从而更好地描述患者的亚组特征。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Changes of intracardiac flow dynamics measured by HyperDoppler in patients with aortic stenosis
Assessment of intracardiac flow dynamics has recently acquired significance due to the development of new measurement methods based on echocardiography. Recent studies have demonstrated that cardiac abnormalities are associated with changes in intracardiac vortical flows. Yet, no previous study assessed the impact of aortic stenosis (AS) on intracardiac vortices. to explore the clinical potential of additional information provided by quantifying intracardiac flow dynamics in patients with AS. One hundred twenty patients with severe AS, sixty patients with concentric remodelling (VR) and hundred controls (CTRL) were prospectively included and underwent non-invasive evaluation of intracardiac flow dynamics. In addition to standard echocardiography, fluid dynamics were assessed by means of HyperDoppler. Vortex depth (p<0.001), vortex length (p=0.003), vortex intensity (p<0.001) and vortex area (p=0.049) were significantly increased in AS compared to CTRL. In addition, mean energy dissipation was significantly higher in AS compared to CTRL (p<0.001) and VR (p=0.002). At ROC analysis, vortex depth showed the best discrimination capacity for AS (p<0.001). Changes in fluid dynamics-based HyperDoppler indices can be reliably assessed in patients with AS. Significant changes in vortex depth and intensity can selectively differentiate AS from both concentric remodelling and healthy controls, suggesting that the assessment of intracardiac flow dynamics may provide complementary information to standard echocardiography to better characterize patients’ subsets.
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