Evaluation of left ventricular diastolic function in patients with uremia by using vector flow mapping

Abstract

Objective To assess the clinical application value of vector flow mapping (VFM) in evaluating the left ventricular diastolic function in patients with uremia. Methods Forty patients with uremia and forty healthy volunteers were enrolled. The quantitative parameters, including vorticity, sum total energy loss (sEL), average energy loss(aEL), and the alteration circulation were measured in the VFM imaging mode. Difference was evaluated between two groups at apical, mid and basal segments at different periods. E/e'was derived via dual-Doppler imaging technology. And correlationship was analyzed between vorticity, sEL, aEL, circulation and E/e', separately. Results ①At apex segment of isovolumetric relaxation time and at three segments of atrial systole, there were difference in vorticity, sEL, aEL between two groups(P<0.05). Circulation in rapid filling phase of anterior mitral valve and slow filling phase of posterior mitral valve were different[(15.94±8.40)m2/s vs (8.36±7.84)m2/s, (5.34±5.24)m2/s vs (13.37±10.42)m2/s, P<0.05]. ②In control group, vorticity, sEL and aEL were different in different segments of same phase or at different phases of same segment, and also did in the uremia group(P<0.01). ③In uremia group, vorticity had a good correlation with E/e'at basal segment of rapid filling phase(r=0.34, P=0.046)and atrial systole(r=0.38, P=0.02). And sEL had a good correlation with E/e'at basal segment of rapid filling phase, isovolumetric relaxation time and at mid segment of rapid filling phase(r1=0.44, P1=0.008; r2=0.48, P2=0.003; r3=0.50, P3=0.002), and in time phase mentioned above, there were also the correlationship between aEL and E/e'(r1=0.39, P1=0.017; r2=0.49, P2=0.002; r3=0.48, P3=0.003). Conclusions VFM can be utilized to analyze 1eft ventricular hemodynamics features of uremia patients and it may be a good supplement for assessing cardiac diastolic function. Key words: Echocardiography; Uremia; Ventricular function, left