目的应用血流向量图(vector flow map,VFM)技术对冠心病前壁心肌梗死患者收缩期左室腔内涡流变化进行连续动态观察,比较前壁心肌梗死对收缩期涡流时间、空间和流体力学协调性的影响。方法收集急性前壁心肌梗死且行冠脉造影术证实为单纯...目的应用血流向量图(vector flow map,VFM)技术对冠心病前壁心肌梗死患者收缩期左室腔内涡流变化进行连续动态观察,比较前壁心肌梗死对收缩期涡流时间、空间和流体力学协调性的影响。方法收集急性前壁心肌梗死且行冠脉造影术证实为单纯前降支病变的患者作为病例组,应用VFM技术观察收缩期心腔内血液流场特点,计算涡流中心位置、持续时间和速度梯度等参数并和正常对照组相比较。结果正常对照组等容收缩期内整体涡流呈左右对称结构,形态规则,流线均匀,涡流中心位于心腔中心点附近。病例组涡流时间、空间及流体力学协调性紊乱,涡流中心偏离心腔中心点,持续时间增大(212.39±56.72 vs 140.81±28.65,P<0.01),射血早期主动脉瓣下血流初速度(40.67±15.93 vs 56.96±14.73,P<0.05)和左室腔内血流速度梯度(17.23±6.48 vs 28.64±7.61,P<0.05)较正常减低。结论前壁心肌梗死造成左室腔内涡流协调性紊乱,流体力学效能降低或心排血量下降。展开更多
Background The factors influencing the q-wave changes in V5 and V6 during anterior acute myocardial in- farction （AMI） have not been thoroughly described. Methods We studied 70 patients with a first anterior AMI, in...Background The factors influencing the q-wave changes in V5 and V6 during anterior acute myocardial in- farction （AMI） have not been thoroughly described. Methods We studied 70 patients with a first anterior AMI, in whom the electrocardiogram （ECG） showed either disappearance of the normal septal q wave （n = 24） or presence of pathological Q wave in V5 and V6 （n = 46） during follow-up. The ECG and coronary angiography findings were correlated. Results There was no difference between the 2 groups in the culprit site proximal to S1 （46% vs. 36%, P = 0.405）, but the culprit site was more frequently located proximal to DI in the group with abnormal Q wave （21% vs. 67%, P = 0.001）. Patients with disappearance of the septal q wave more often had a large obtuse marginal branch （46 % vs. 22%, P = 0.037） and disappearance of the r wave in V1 （88% vs. 7%, P = 0.001）. Patients with abnormal Q-wave more often had a large LAD （42% vs. 71%）, small r wave or tall or wide R wave in V1 （0 % vs. 89 %, P = 0.001） and abnormal Q waves in the inferior leads （33% vs. 59%, P = 0.044）. Conclusions In patients with first anterior AMI, q wave changes in V5 and V6 correlated with the morphology in V1. Emerging abnormal Q wave in Vs/V6 predicted the culprit lesion in a large LAD proximal to D1, but disappearance of the septal q wave could not predict the culprit lesion proximal to S1.展开更多
文摘目的应用血流向量图(vector flow map,VFM)技术对冠心病前壁心肌梗死患者收缩期左室腔内涡流变化进行连续动态观察,比较前壁心肌梗死对收缩期涡流时间、空间和流体力学协调性的影响。方法收集急性前壁心肌梗死且行冠脉造影术证实为单纯前降支病变的患者作为病例组,应用VFM技术观察收缩期心腔内血液流场特点,计算涡流中心位置、持续时间和速度梯度等参数并和正常对照组相比较。结果正常对照组等容收缩期内整体涡流呈左右对称结构,形态规则,流线均匀,涡流中心位于心腔中心点附近。病例组涡流时间、空间及流体力学协调性紊乱,涡流中心偏离心腔中心点,持续时间增大(212.39±56.72 vs 140.81±28.65,P<0.01),射血早期主动脉瓣下血流初速度(40.67±15.93 vs 56.96±14.73,P<0.05)和左室腔内血流速度梯度(17.23±6.48 vs 28.64±7.61,P<0.05)较正常减低。结论前壁心肌梗死造成左室腔内涡流协调性紊乱,流体力学效能降低或心排血量下降。
基金supported by Hubei Provincial Department of Education (No. Q20102102)
文摘Background The factors influencing the q-wave changes in V5 and V6 during anterior acute myocardial in- farction （AMI） have not been thoroughly described. Methods We studied 70 patients with a first anterior AMI, in whom the electrocardiogram （ECG） showed either disappearance of the normal septal q wave （n = 24） or presence of pathological Q wave in V5 and V6 （n = 46） during follow-up. The ECG and coronary angiography findings were correlated. Results There was no difference between the 2 groups in the culprit site proximal to S1 （46% vs. 36%, P = 0.405）, but the culprit site was more frequently located proximal to DI in the group with abnormal Q wave （21% vs. 67%, P = 0.001）. Patients with disappearance of the septal q wave more often had a large obtuse marginal branch （46 % vs. 22%, P = 0.037） and disappearance of the r wave in V1 （88% vs. 7%, P = 0.001）. Patients with abnormal Q-wave more often had a large LAD （42% vs. 71%）, small r wave or tall or wide R wave in V1 （0 % vs. 89 %, P = 0.001） and abnormal Q waves in the inferior leads （33% vs. 59%, P = 0.044）. Conclusions In patients with first anterior AMI, q wave changes in V5 and V6 correlated with the morphology in V1. Emerging abnormal Q wave in Vs/V6 predicted the culprit lesion in a large LAD proximal to D1, but disappearance of the septal q wave could not predict the culprit lesion proximal to S1.
