Evaluation of energy loss and wall shear stress in the left ventricle by vector flow mapping in patients with dilated cardiomyopathy

doi:10.3877/cma.j.issn.1672-6448.2021.10.010

Abstract

Abstract:

Objective

To quantitatively assess the left ventricular dysfunction in patients with dilated cardiomyopathy (DCM) by vector flow mapping (VFM) technique.

Methods

From January 2019 to April 2019, 29 patients diagnosed as having DCM who came to Wuhan Asia Heart Hospital were selected as a DCM group. And 32 healthy volunteers were enrolled as a control group during the same period. The hemodynamic images of two-dimensional color Doppler in apical four-chamber and three-chamber views were acquired in VFM. The above images were off-machine analyzed, and the differences in the average energy loss (EL) and wall shear stress (WSS) in the isovolumic contraction period (P0), rapid ejection period (P1), isovolumic relaxation period (P2), rapid filling period (P3), and atrial contraction period (P4) were compared between the two groups. Then, the changes of left ventricular hemodynamics in patients with DCM were evaluated.

Results

Compared with the control group, EL in the DCM group decreased at P0, P1, and P3 [(2.24±1.33)J/(s·m³) vs (1.39±0.49) J/(s·m³), (6.14±3.58) J/(s·m³) vs (4.17±2.12) J/(s·m³), (10.38±6.67) J/(s·m³) vs (4.92±2.73) J/(s·m³), P＜0.05]. In the DCM group, the WSS values of basal segment at P0 [(0.45±0.30) N/m² vs (0.23±0.13) N/m², P＜0.01], basal and middle sections at P1 and P2 [(1.24±0.39) N/m² vs (0.93±0.40) N/m², (0.55±0.30) N/m² vs (0.36±0.23) N/m², (0.29±0.08) N/m² vs (0.12±0.05) N/m², (0.14±0.08) N/m² vs (0.10±0.06) N/m², P＜0.05], all sections at P3 [(0.60±0.24) N/m² vs (0.26±0.08) N/m², (0.47±0.29) N/m² vs (0.14±0.04) N/m², (0.13±0.06) N/m² vs (0.06±0.02) N/m², P＜0.01], and basal segment at P4 [(0.40±0.15) N/m² vs (0.25±0.12) N/m², P＜0.01] were significantly lower. At the same phase, the WSS values from basal to middle and apical segments showed a decreasing trend in the control group. However, there was no significant difference between basal and middle segments in the DCM group at P0, P2, and P4 (P＞0.05). The WSS value at every section from P0 to P4 showed an increasing-decreasing-increasing-decreasing trend in the control group (P＜0.05). In the DCM patients, however, the WSS value only at the basal segment from P0 to P3 showed an increasing-decreasing-increasing trend (P＜0.05), with no significant difference observed at other segments between adjacent phases.

Conclusion

The EL and WSS as new hemodynamic quantitative parameters in the VFM technique, can be used to evaluate left ventricular dysfunction in DCM patients.

Key words: Vector flow mapping, Cardiomyopathy, dilated, Energy loss, Wall shear stress

Guan Cheng, Juan Xia, Xiaojing Ma. Evaluation of energy loss and wall shear stress in the left ventricle by vector flow mapping in patients with dilated cardiomyopathy[J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2021, 18(10): 954-959.

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URL: https://chaosheng.cma-cmc.com.cn/EN/10.3877/cma.j.issn.1672-6448.2021.10.010

https://chaosheng.cma-cmc.com.cn/EN/Y2021/V18/I10/954

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References 18

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组别	男/女（例）	年龄（岁）	心率（次/分）	BSA（m²）	LVEF（%）	LVEDD（cm）	LVESD（cm）	E（m/s）	A（m/s）	E/A
对照组（n=32）	18/14	47.9±9.5	75.0±9.2	1.63±0.14	58.7±1.3	4.47±0.24	2.97±0.31	0.78±0.15	0.70±0.15	1.18±0.38
DCM组（n=29）	17/12	51.4±10.7	79.5±13.4	1.62±0.16	34.4±8.5	6.53±0.66	5.04±0.67	0.77±0.25	0.85±0.22	0.93±0.43
t值	0.049	-1.356	-1.518	0.456	15.224	-15.846	-15.224	0.171	-3.170	2.395
P值	0.852	0.180	0.135	0.650	＜0.01	＜0.01	＜0.01	0.865	0.003	0.020

组别	男/女（例）	年龄（岁）	心率（次/分）	BSA（m²）	LVEF（%）	LVEDD（cm）	LVESD（cm）	E（m/s）	A（m/s）	E/A
对照组（n=32）	18/14	47.9±9.5	75.0±9.2	1.63±0.14	58.7±1.3	4.47±0.24	2.97±0.31	0.78±0.15	0.70±0.15	1.18±0.38
DCM组（n=29）	17/12	51.4±10.7	79.5±13.4	1.62±0.16	34.4±8.5	6.53±0.66	5.04±0.67	0.77±0.25	0.85±0.22	0.93±0.43
t值	0.049	-1.356	-1.518	0.456	15.224	-15.846	-15.224	0.171	-3.170	2.395
P值	0.852	0.180	0.135	0.650	＜0.01	＜0.01	＜0.01	0.865	0.003	0.020

组别	P0	P1	P2	P3	P4
对照组（n=32）	2.24±1.33	6.14±3.58	0.52±0.32	10.38±6.67	5.20±3.89
DCM组（n=29）	1.39±0.49	4.17±2.12	0.41±0.27	4.92±2.73	5.14±3.02
t值	3.407	2.587	1.462	4.254	0.066
P值	0.002	0.012	0.149	＜0.01	0.948

组别	P0	P1	P2	P3	P4
对照组（n=32）	2.24±1.33	6.14±3.58	0.52±0.32	10.38±6.67	5.20±3.89
DCM组（n=29）	1.39±0.49	4.17±2.12	0.41±0.27	4.92±2.73	5.14±3.02
t值	3.407	2.587	1.462	4.254	0.066
P值	0.002	0.012	0.149	＜0.01	0.948

组别	P0			P1			P2
组别	基底段	中间段	心尖段	基底段	中间段	心尖段	基底段	中间段	心尖段
对照组（n=32）	0.45±0.30	0.30±0.22	0.11±0.07	1.24±0.39	0.55±0.30	0.08±0.02	0.29±0.08	0.14±0.08	0.06±0.02
DCM组（n=29）	0.23±0.13	0.26±0.17	0.11±0.06	0.93±0.40	0.36±0.23	0.07±0.03	0.12±0.05	0.10±0.06	0.06±0.03
t值	3.929	0.936	-0.026	3.140	2.795	1.739	3.928	3.196	0.282
P值	＜0.01	0.353	0.979	0.003	0.007	0.087	＜0.01	0.002	0.779
组别	P3				P4
组别	基底段	中间段	心尖段		基底段	中间段	心尖段
对照组（n=32）	0.60±0.24	0.47±0.29	0.13±0.06		0.40±0.15	0.27±0.14	0.10±0.07
DCM组（n=29）	0.26±0.08	0.14±0.04	0.06±0.02		0.25±0.12	0.25±0.16	0.10±0.07
t值	7.662	6.433	6.285		4.323	0.495	-0.040
P值	＜0.01	＜0.01	＜0.01		＜0.01	0.622	0.968

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