目的：探讨慢性心力衰竭（CHF）患者左心室内血流自收缩射血向舒张充盈血流逆转的规律。资料与方法选取25例CHF患者作为CHF组，并选取28例健康人作为对照组。测定射血-充盈血流逆转间期（FRI）、校正射血-充盈血流逆转间期（CFRI）、射血-充盈血流逆转流率（FRR）、左心室射血期峰值流率（FRPE），比较两组左心室流体力学参数的差异。结果与对照组相比，CHF患者左心室涡流FRI延长[（71±13）ms 对（113±30）ms，P<0.05）]，FRR 减低[（46.85±21.35）cm2/s 对（27.90±16.77）cm2/s，P<0.05）]，FRPE减低[（74.54±9.10）cm2/s对（41.12±17.25）cm2/s， P<0.05）]。FRI、CFRI与Tei指数呈正相关（r=0.812、0.849，P<0.01），FRI与左心室射血分数（LVEF）、短轴缩短率（FS）、每搏量（SV）、心输出量（CO）、心指数（CI）呈负相关（r=－0.646~－0.515，P<0.05、P<0.01）；CFRI与LVEF、FS、SV、CO、CI呈负相关（r=－0.685~－0.456，P<0.05、P<0.01）；FRR与Tei指数呈负相关（r=－0.604，P<0.05），与LVEF、FS、SV、CO、CI呈正相关（r=0.503~0.812， P<0.05、P<0.01）；FRPE与Tei指数呈负相关（r=－0.734，P<0.01），与LVEF、FS、SV、CO、CI呈正相关（r=0.557~0.776，P<0.05、P<0.01）。结论超声血流向量成像能够直观地显示并定量分析CHF患者左心室的流体力学变化，左心室内血流方向逆转效率可以作为判断CHF治疗效果的指标之一。%PurposeTo explore the left ventricle flow propagation process in patients with chronic heart failure (CHF) using velocity flow mapping. Materials and Methods Patients with CHF (n=25) were selected as CHF group. Healthy subjects (n=28) were chosen as the control group. Flow reversal interval (FRI), flow reversal rate (FRR), corrected flow reversal rate (CFRI) and flow rate in peak ejection (FRPE) were measured. Parameters related to the vortex in CHF group were compared with that in the control group. Results Compared with the control group, FRI was longer [(71±13) msvs. (113±30) ms, P<0.05], FRR and FRPE were lower [(46.85±21.35) cm2/svs. (27.90±16.77) cm2/s;(74.54±9.10) cm2/svs. (41.12±17.25) cm2/s,P<0.05] in CHF group. FRI and CFRI were positively correlated with the Tei index (r=0.812 and 0.849,P<0.01). FRI was negatively correlated with LVEF, FS, SV, CO, CI (r=-0.646--0.515,P<0.05 orP<0.01). CFRI was negatively correlated with LVEF, FS, SV, CO and CI (r=-0.685--0.456,P<0.05 orP<0.01); FRR was negatively correlated with Tei index (r=-0.604,P<0.05), and was positively correlated with LVEF, FS, SV, CO and CI (r=0.503-0.812,P<0.05 orP<0.01);FRPE was negatively correlated with Tei index (r=-0.734,P<0.01), and were positively correlated with LVEF, FS, SV, CO and CI (r=0.557-0.776,P<0.05 orP<0.01).Conclusion Velocity flow mapping can demonstratecardiac hydromechanics in patients with chronic heart failure. The heart blood flow direction reversal efficiency may be a new method for diagnosis and treatment evaluation.
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