Evaluation of left ventricular energy loss in gout patients using ultrasonic vector flow mapping

doi:10.3877/cma.j.issn.1672-6448.2022.06.007

Abstract

Abstract:

Objective

To evaluate the clinical value of ultrasonic vector flow mapping (VFM) in the evaluation of left ventricular energy loss in gout patients.

Methods

Hospitalized gout patients (gout group, n=45) and healthy people who had underwent physical examination (control group, n=40) at Sichuan Provincial People's Hospital from December 2019 to June 2020 were enrolled. Based on the course of gout, gout patients were divided into either a long-course subgroup (n=24) or a short-course subgroup (n=21). According to their age, both gout patients and control people were divided into either an aged subgroup (n=22 for gout patients and n=20 for controls) or a young subgroup (n=23 for gout patients and n=20 for controls). All subjects underwent transthoracic echocardiographic examination, and conventional echocardiographic parameters were derived. By using a dedicated VFM workstation, the average energy loss (EL) was obtained offline in seven phases (P1-P7): isovolumic diastole (P1), early diastole (P2), mid-diastole (P3), late diastole (P4), isovolumic systole (P5), early systole (P6), and late systole (P7). The differences in the parameters were statistically analyzed between the gout group and control group, and between each subgroup. The correlation between traditional cardiac function parameters and corrected EL (ELc), and the correlation of ELc with age and the course of gout were also statistically analyzed.

Results

ELcP3, ELcP6, and ELcP7 in the gout group were statistically higher than those of the control group (P＜0.05). Age, E/e, ELcP4, and ELcP5 in the long-course subgroup were statistically higher than those of the short-course subgroup (P＜0.05). E/e and ELcP3 in the aged gout subgroup were statistically higher than those of the aged control subgroup (P＜0.05), while ELcP3 and ELcP6 of the young gout subgroup were statistically higher than those of the young control subgroup (P＜0.05). Correlation analysis of diastolic parameters showed that ELcP2 and ELcP4 had a positive correlation with E/e (r=0.306 and 0.405, respectively; P＜0.01), and that ELcP4 had a negative correlation with E/A (r=-0.364, P＜0.01). Besides, there was a positive correlation between diastolic ELcP2 and E/A (r=0.409, P＜0.01). Correlation analysis of systolic parameters showed that there was a positive correlation between ELcP6 and LVEF (r=0.306, P＜0.01). ELcP4 and ELcP5A had a positive correlation with age (r=0.622 and 0.671, respectively; P＜0.01), and ELcP4, ELcP5, and ELcP7 had a positive correlation with the disease course (r=0.433, 0.465, and 0.300, respectively; P＜0.01).

Conclusion

VFM can quantitatively evaluate left ventricular blood flow field of gout patients. Early mild left ventricular diastolic and systolic dysfunction have occurred in gout patients, and the severity of dysfunction might be related with age and the course of gout. Ultrasound quantitative evaluation of intracardiac blood fluid energy loss parameters is expected to be a new method to detect early left ventricular diastolic and systolic dysfunction in gout patients.

Key words: Echocardiography, Vector flow mapping, Gout, Ventricular function, left

Zhe Yang, Lixue Yin, Sijia Wang, Suqiu Luo, Xin Zhao, Qiao Zhou, Jiang Su, Rui Wu. Evaluation of left ventricular energy loss in gout patients using ultrasonic vector flow mapping[J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2022, 19(06): 527-534.

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URL: https://chaosheng.cma-cmc.com.cn/EN/10.3877/cma.j.issn.1672-6448.2022.06.007

https://chaosheng.cma-cmc.com.cn/EN/Y2022/V19/I06/527

Figures/Tables 5

参数	例数	年龄［岁，M（Q_R）或 $x ¯$ ±s］	BSA （m²， $x ¯$ ±s）	BMI （kg/m²， $x ¯$ ±s）	收缩压（mmHg， $x ¯$ ±s）	舒张压［mmHg，M（Q_R）或 $x ¯$ ±s］	心率（次/min， $x ¯$ ±s）
痛风组	45	40.00（16.50）	1.84±0.17	25.01±2.32	122.33±9.79	82.00（13.00）	65.40±4.25
对照组	40	42.00（19.50）	1.78±0.14	23.97±2.84	123.03±7.90	79.50（9.75）	64.51±4.66
统计值		Z=-0.648	t=1.844	t=1.863	t=-0.355	Z=-1.226	t=0.918
P值		0.517	0.069	0.066	0.723	0.220	0.361
长病程组	24	45.17±10.75	1.81±0.15	25.11±2.01	122.17±9.83	82.50（11.25）	65.54±4.91
短病程组	21	34.29±8.16	1.87±0.18	24.90±2.67	122.52±9.99	81.00（14.00）	65.24±3.45
统计值		t=3.781	t=-1.241	t=0.295	t=-0.121	Z=-0.034	t=0.231
P值		＜0.01	0.221	0.770	0.905	0.973	0.819
中年痛风组	22	48.00（7.25）	1.78±0.13	25.11±1.71	121.23±9.65	83.00（13.50）	65.78±5.21
中年对照组	20	51.50（11.75）	1.75±0.10	24.37±3.18	122.20±8.08	77.50（10.00）	65.08±4.50
统计值		Z=-1.010	t=1.060	t=0.925	t=-0.352	Z=-1.728	t=0.458
P值		0.313	0.296	0.363	0.726	0.084	0.650
青年痛风组	23	30.83±4.25	1.89±0.19	24.91±2.82	123.39±10.03	79.39±7.13	65.04±3.14
青年对照组	20	31.50±5.24	1.81±0.16	23.56±2.46	123.85±7.85	80.15±7.50	63.94±4.87
统计值		t=-0.466	t=1.545	t=1.662	t=-0.165	t=-0.396	t=0.866
P值		0.644	0.130	0.104	0.870	0.694	0.393

参数	例数	年龄［岁，M（Q_R）或 $x ¯$ ±s］	BSA （m²， $x ¯$ ±s）	BMI （kg/m²， $x ¯$ ±s）	收缩压（mmHg， $x ¯$ ±s）	舒张压［mmHg，M（Q_R）或 $x ¯$ ±s］	心率（次/min， $x ¯$ ±s）
痛风组	45	40.00（16.50）	1.84±0.17	25.01±2.32	122.33±9.79	82.00（13.00）	65.40±4.25
对照组	40	42.00（19.50）	1.78±0.14	23.97±2.84	123.03±7.90	79.50（9.75）	64.51±4.66
统计值		Z=-0.648	t=1.844	t=1.863	t=-0.355	Z=-1.226	t=0.918
P值		0.517	0.069	0.066	0.723	0.220	0.361
长病程组	24	45.17±10.75	1.81±0.15	25.11±2.01	122.17±9.83	82.50（11.25）	65.54±4.91
短病程组	21	34.29±8.16	1.87±0.18	24.90±2.67	122.52±9.99	81.00（14.00）	65.24±3.45
统计值		t=3.781	t=-1.241	t=0.295	t=-0.121	Z=-0.034	t=0.231
P值		＜0.01	0.221	0.770	0.905	0.973	0.819
中年痛风组	22	48.00（7.25）	1.78±0.13	25.11±1.71	121.23±9.65	83.00（13.50）	65.78±5.21
中年对照组	20	51.50（11.75）	1.75±0.10	24.37±3.18	122.20±8.08	77.50（10.00）	65.08±4.50
统计值		Z=-1.010	t=1.060	t=0.925	t=-0.352	Z=-1.728	t=0.458
P值		0.313	0.296	0.363	0.726	0.084	0.650
青年痛风组	23	30.83±4.25	1.89±0.19	24.91±2.82	123.39±10.03	79.39±7.13	65.04±3.14
青年对照组	20	31.50±5.24	1.81±0.16	23.56±2.46	123.85±7.85	80.15±7.50	63.94±4.87
统计值		t=-0.466	t=1.545	t=1.662	t=-0.165	t=-0.396	t=0.866
P值		0.644	0.130	0.104	0.870	0.694	0.393

参数	例数	LAD［mm， M（Q_R）或 $x ¯$ ±s］	LVDd （mm， $x ¯$ ±s）	IVSd［mm，M（Q_R）］	LVPWd［mm，M（Q_R）或 $x ¯$ ±s］	E/A ［M（Q_R）或 $x ¯$ ±s］	E/e［M（Q_R）或 $x ¯$ ±s］	LVEF［%，M（Q_R）或 $x ¯$ ±s］
痛风组	45	30.58±3.58	43.80±3.81	8.00（2.00）	8.00（2.00）	1.23±0.37	5.96（2.74）	63.40（7.70）
对照组	40	30.48±2.92	44.58±4.73	8.00（1.00）	8.00（1.00）	1.28±0.31	5.59（1.75）	62.00（8.60）
统计值		t=0.146	t=-0.567	Z=-0.028	Z=-0.945	t=-0.689	Z=-1.227	Z=-0.797
P值		0.884	0.572	0.978	0.344	0.493	0.220	0.426
长病程组	24	30.50±3.72	43.63±3.81	8.00（2.00）	7.83±1.01	1.15±0.34	6.73±1.73	63.64±5.11
短病程组	21	30.67±3.50	44.00±3.89	8.00（1.00）	7.95±1.24	1.31±0.39	5.65±1.46	64.55±4.87
统计值		t=-0.154	t=-0.326	Z=-0.584	t=-0.355	t=-1.469	t=2.228	t=-0.609
P值		0.878	0.746	0.559	0.725	0.149	0.031	0.545
中年痛风组	22	29.50（6.25）	43.32±3.77	8.00（1.25）	8.14±1.13	1.10（0.42）	7.38（2.72）	62.92±4.76
中年对照组	20	30.00（4.50）	43.35±4.08	8.00（2.00）	7.67±0.89	1.17（0.55）	6.04（1.83）	62.92±8.04
统计值		Z=-1.063	t=0.026	Z=-0.823	t=1.247	Z=-0.744	Z=-2.217	t=0.004
P值		0.288	0.979	0.410	0.221	0.457	0.027	0.997
青年痛风组	23	31.43±3.30	44.26±3.86	8.00（1.00）	8.00（2.00）	1.39±0.37	4.93（1.72）	65.16±5.01
青年对照组	20	30.25±3.40	45.30±5.21	8.00（1.00）	8.00（1.00）	1.45±0.21	5.10（1.62）	62.70±5.80
统计值		t=1.158	t=-0.749	Z=-1.031	Z=-0.118	t=-0.606	Z=-0.353	t=1.496
P值		0.254	0.458	0.303	0.906	0.548	0.724	0.142

参数	例数	LAD［mm， M（Q_R）或 $x ¯$ ±s］	LVDd （mm， $x ¯$ ±s）	IVSd［mm，M（Q_R）］	LVPWd［mm，M（Q_R）或 $x ¯$ ±s］	E/A ［M（Q_R）或 $x ¯$ ±s］	E/e［M（Q_R）或 $x ¯$ ±s］	LVEF［%，M（Q_R）或 $x ¯$ ±s］
痛风组	45	30.58±3.58	43.80±3.81	8.00（2.00）	8.00（2.00）	1.23±0.37	5.96（2.74）	63.40（7.70）
对照组	40	30.48±2.92	44.58±4.73	8.00（1.00）	8.00（1.00）	1.28±0.31	5.59（1.75）	62.00（8.60）
统计值		t=0.146	t=-0.567	Z=-0.028	Z=-0.945	t=-0.689	Z=-1.227	Z=-0.797
P值		0.884	0.572	0.978	0.344	0.493	0.220	0.426
长病程组	24	30.50±3.72	43.63±3.81	8.00（2.00）	7.83±1.01	1.15±0.34	6.73±1.73	63.64±5.11
短病程组	21	30.67±3.50	44.00±3.89	8.00（1.00）	7.95±1.24	1.31±0.39	5.65±1.46	64.55±4.87
统计值		t=-0.154	t=-0.326	Z=-0.584	t=-0.355	t=-1.469	t=2.228	t=-0.609
P值		0.878	0.746	0.559	0.725	0.149	0.031	0.545
中年痛风组	22	29.50（6.25）	43.32±3.77	8.00（1.25）	8.14±1.13	1.10（0.42）	7.38（2.72）	62.92±4.76
中年对照组	20	30.00（4.50）	43.35±4.08	8.00（2.00）	7.67±0.89	1.17（0.55）	6.04（1.83）	62.92±8.04
统计值		Z=-1.063	t=0.026	Z=-0.823	t=1.247	Z=-0.744	Z=-2.217	t=0.004
P值		0.288	0.979	0.410	0.221	0.457	0.027	0.997
青年痛风组	23	31.43±3.30	44.26±3.86	8.00（1.00）	8.00（2.00）	1.39±0.37	4.93（1.72）	65.16±5.01
青年对照组	20	30.25±3.40	45.30±5.21	8.00（1.00）	8.00（1.00）	1.45±0.21	5.10（1.62）	62.70±5.80
统计值		t=1.158	t=-0.749	Z=-1.031	Z=-0.118	t=-0.606	Z=-0.353	t=1.496
P值		0.254	0.458	0.303	0.906	0.548	0.724	0.142

组别	例数	ELcP1	ELcP2	ELcP3	ELcP4	ELcP5	ELcP6	ELcP7［M（Q_R）或 $x ¯$ ±s］
痛风组	45	1.20（1.15）	6.94（5.21）	2.92（2.41）	3.33（2.99）	3.36（2.80）	3.96（3.25）	2.30（1.35）
对照组	40	0.79（1.26）	5.25（5.98）	2.00（1.67）	3.00（2.29）	3.09（2.26）	3.13（2.75）	1.96（1.71）
Z值		-1.708	-1.470	-3.280	-1.118	-0.696	-2.659	-2.016
P值		0.088	0.141	0.001	0.263	0.487	0.008	0.039
长病程组	24	1.21（1.33）	7.38（4.93）	2.81（2.85）	4.71（3.17）	4.36（2.79）	4.09（3.24）	2.59（1.60）
短病程组	21	1.04（1.07）	6.11（7.37）	3.36（2.69）	2.70（1.15）	2.72（2.14）	3.96（3.31）	2.23（0.85）
Z值		-1.001	-0.739	-0.466	-2.525	-2.366	-0.592	-0.978
P值		0.317	0.460	0.641	0.012	0.018	0.554	0.328
中年痛风组	22	1.30（1.12）	6.88（4.60）	3.36（2.59）	5.24（2.84）	5.08（2.51）	4.73（4.30）	2.62（2.03）
中年对照组	20	0.85（1.39）	4.88（2.73）	1.98（1.97）	3.81（3.37）	4.14（2.71）	3.97（3.85）	2.48（1.85）
Z值		-1.045	-1.939	-2.556	-1.876	-1.285	-1.612	-1.285
P值		0.296	0.052	0.011	0.061	0.199	0.107	0.199
青年痛风组	23	0.93（1.39）	6.94（7.90）	2.70（2.25）	2.50（1.23）	2.41（0.90）	3.48（2.16）	2.30±0.78
青年对照组	20	0.65（0.75）	6.02（10.97）	2.00（1.41）	2.66（1.23）	2.31（1.04）	2.70（2.12）	1.95±0.83
统计值		Z=-1.449	Z=-0.304	Z=-2.167	Z=-0.511	Z=-0.219	Z=-2.386	t=1.564
P值		0.147	0.761	0.030	0.609	0.826	0.017	0.126

组别	例数	ELcP1	ELcP2	ELcP3	ELcP4	ELcP5	ELcP6	ELcP7［M（Q_R）或 $x ¯$ ±s］
痛风组	45	1.20（1.15）	6.94（5.21）	2.92（2.41）	3.33（2.99）	3.36（2.80）	3.96（3.25）	2.30（1.35）
对照组	40	0.79（1.26）	5.25（5.98）	2.00（1.67）	3.00（2.29）	3.09（2.26）	3.13（2.75）	1.96（1.71）
Z值		-1.708	-1.470	-3.280	-1.118	-0.696	-2.659	-2.016
P值		0.088	0.141	0.001	0.263	0.487	0.008	0.039
长病程组	24	1.21（1.33）	7.38（4.93）	2.81（2.85）	4.71（3.17）	4.36（2.79）	4.09（3.24）	2.59（1.60）
短病程组	21	1.04（1.07）	6.11（7.37）	3.36（2.69）	2.70（1.15）	2.72（2.14）	3.96（3.31）	2.23（0.85）
Z值		-1.001	-0.739	-0.466	-2.525	-2.366	-0.592	-0.978
P值		0.317	0.460	0.641	0.012	0.018	0.554	0.328
中年痛风组	22	1.30（1.12）	6.88（4.60）	3.36（2.59）	5.24（2.84）	5.08（2.51）	4.73（4.30）	2.62（2.03）
中年对照组	20	0.85（1.39）	4.88（2.73）	1.98（1.97）	3.81（3.37）	4.14（2.71）	3.97（3.85）	2.48（1.85）
Z值		-1.045	-1.939	-2.556	-1.876	-1.285	-1.612	-1.285
P值		0.296	0.052	0.011	0.061	0.199	0.107	0.199
青年痛风组	23	0.93（1.39）	6.94（7.90）	2.70（2.25）	2.50（1.23）	2.41（0.90）	3.48（2.16）	2.30±0.78
青年对照组	20	0.65（0.75）	6.02（10.97）	2.00（1.41）	2.66（1.23）	2.31（1.04）	2.70（2.12）	1.95±0.83
统计值		Z=-1.449	Z=-0.304	Z=-2.167	Z=-0.511	Z=-0.219	Z=-2.386	t=1.564
P值		0.147	0.761	0.030	0.609	0.826	0.017	0.126

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