Assessment of left ventricular wall shear stress at each segment in non-obstructive hypertrophic cardiomyopathy using vector flow mapping
10.3760/cma.j.cn131148-20250117-00027
- VernacularTitle:血流向量成像技术评价非梗阻性肥厚型心肌病患者左心室各节段室壁剪应力
- Author:
Yan YANG
1
;
Dan XUE
1
;
Yuxin ZHANG
1
;
Changyang XING
1
;
Lijun YUAN
1
;
Yunyou DUAN
1
Author Information
1. 空军军医大学唐都医院超声医学科，西安 710038
- Publication Type:Journal Article
- Keywords:
Echocardiography;
Vector flow mapping;
Cardiomyopathy，hypertrophic;
Wall shear stress;
Ventricular function，left
- From:
Chinese Journal of Ultrasonography
2025;34(6):496-503
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To assess the clinical utility of vector flow mapping（VFM）for evaluating left ventricular wall shear stress（WSS）in individuals with non-obstructive hypertrophic cardiomyopathy（nHCM）.Methods:Forty patients with non-obstructive HCM（nHCM）and 46 healthy volunteers in Tangdu Hospital of Air Force Medical University from May 2020 to September 2023 were enrolled prospectively in this study. The left ventricular WSS of each of 18 segments was measured and analyzed by VFM during rapid filling phase（T1），slow filling phase（T2），isovolumetric contraction phase（T3）and rapid ejection phase（T4）.Results:① WSS decreased gradually from basal to apical segments in control group，while there was no such change pattern in nHCM group. ② Diastolic phase：When compared to the control group，the nHCM group demonstrated significantly increased WSS across all segments of the inferoseptal regions，the basal anteroseptal segment，and the middle and apical inferior segments during the T1 stage. Additionally，at the T2 stage，the WSS was significantly higher in the nHCM group across all segments of the inferoseptal and anteroseptal regions，the basal anterolateral segment，and the apical inferolateral and anterior segments（all P<0.05）. Conversely，during the T1 stage，the basal anterolateral segment，basal inferolateral segment，and the middle and apical anteroseptal segments，as well as during the T2 stage，the basal and middle inferior segments，exhibited lower WSS values compared to the control group，with these differences being statistically significant（all P<0.05）. ③Systolic Phase：During the T3 stage，the WSS values in all segments of the anteroseptal and anterolateral regions，as well as the apical inferior and anterior segments，were significantly elevated in the nHCM group compared to the control group（all P<0.05）.At the T4 stage，WSS in each segment of the inferolateral and inferior regions，as well as the basal and middle anterior segments，was significantly elevated in the nHCM group compared to the control group（all P<0.01）. Conversely，during the same stage，the WSS values in the basal inferolateral segment，the basal and middle anterolateral segments，and the basal and middle anteroseptal segments were significantly lower in the nHCM group than in the control group，with all differences reaching statistical significance（all P<0.01）.Regarding global WSS，the left ventricular global WSS in the nHCM group was significantly higher than that in the control group at both the T2 and T3 stages（all P<0.001）. Furthermore，the global WSS at the T3 stage was negatively correlated with left ventricular end-systolic volume，end-diastolic volume，and left ventricular stroke volume（ r=-0.226， P=0.036； r=-0.345， P=0.001； r=-0.303， P=0.005）. Conclusions:Significant differences in WSS are observed between patients with nHCM and control groups at various phases. WSS may serve as an early indicator of changes in cardiac function in nHCM patients.
