在心房切换手术后,全身右心室内腔内血流动力学:从横向向纵向缩模式的转变
Giulia Pasqualin1, Alessandra Riva2, Francesco Sturla2,3
1Pediatric and Adult Congenital Disease Heart Centre, IRCCS Policlinico San Donato, Piazza E. Malan 2, San Donato Milanese, 20097, Italy. giulia.pasqualin@grupposandonato.it.
The international journal of cardiovascular imaging
|March 24, 2025
概括
在TGA/AS患者中,全身右心室 (SRV) 衰竭显示出变化的腔内血流. 缩期间的SRV血液动力学类似于左心室,而腹缩填充类似于右心室.
科学领域:
- 心血管生理学心血管生理学
- 医疗成像医学成像
- 遗传性心脏病是一种先天性心脏病.
背景情况:
- 系统性右心室 (SRV) 衰竭源于右心室和左心室 (RV和LV) 之间的形态差异.
- 对系统后负荷的RV适应涉及周围心肌应变的增加,但其对内腔内血动力学的影响尚未完全理解.
研究的目的:
- 在心房开关操作 (TGA/AS) 后大动脉转移的患者的SRV中,研究内血流的模式,用血动力力 (HDF) 来量化.
- 探索SRV HDF与心室壁力学之间的关系.
主要方法:
- 使用4D流磁共振成像 (MRI) 在12名成年TGA/AS患者和12名健康对照中.
- 量化HDF在顶点-基点,侧面-septal和下部-前部方向.
- 评估了缩和腹缩期间横向平方根与纵向HDF (RRMS) 的比率.
主要成果:
- 在TGA/AS SRV中,缩RRMS值与健康LV相似,但明显低于健康RV.
- 在SRV中观察到系统性HDF大小,RRMS值和自由壁周围应变 (FWCS) 之间存在强烈的相关性.
- 在TGA/AS SRV中,透缩性HDF低于对照LV,并显示RRMS值与RV相似.
结论:
- 在TGA/AS患者中,SRV结构和功能显著影响内腔内血动力学,与健康的LV和RV不同.
- 在SRV中,静脉血动力学转向LV模式,可能是由于增加了FWCS.
- SRV 的透缩填充似乎与腹腔形态密切相关,RRMS值类似于RVs的值.
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