超音波検査技術

ISSN: 1881-4506
一般社団法人日本超音波検査学会
〒162-0801 東京都新宿区山吹町358-5
Japanese Journal of Medical Ultrasound Technology 47(1): 22-30 (2022)
doi:10.11272/jss.351

研究Research Paper

vector flow mappingで観察した若年健常者における拡張期左室内渦流の特徴Characterization of the Left Ventricular Diastolic Vortex in Healthy Young Adults Using Vector Flow Mapping

梶原 由佳梨1，林 莉穂1，花園 麻璃亜1，小室 拓也2，豊田 紋子3，藤井 彩乃3，田中 智子3，有吉 亨3，和田 靖明3，田中 伸明2Yukari Kajihara1, Riho Hayashi1, Maria Hanazono1, Takuya Omuro2, Ayako Toyota3, Ayano Fujii3, Tomoko Tanaka3, Toru Ariyoshi3, Yasuaki Wada3, Nobuaki Tanaka2

1 山口大学医学部保健学科検査技術科学専攻Department of Laboratory Science, Yamaguchi University School of Health Science

2 山口大学大学院医学系研究科保健学専攻病態検査学講座Department of Clinical Laboratory Sciences, Yamaguchi University Graduate School of Medicine

3 山口大学医学部附属病院検査部Division of Laboratory, Yamaguchi University Hospital

受付日：2021年5月21日Received: May 21, 2021
受理日：2021年11月15日Accepted: November 15, 2021
発行日：2022年2月1日Published: February 1, 2022
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目的：若年健常者における拡張期左室内渦流の特徴をvector flow mapping（VFM）を用いて検討した．

対象と方法：健常成人28人（男性16人，平均年齢22±1歳）を対象とし，心尖部左室長軸像にてVFM解析用画像を記録した．渦流の定性および定量はCirculation（m2/s）を用いた．拡張期を早期，中期，心房収縮期に分け，左室内渦流の出現部位と出現率を観察し，Circulationと心エコー図検査の各計測値との関連を検討した．

結果と考察：拡張期における渦流は，拡張早期の僧帽弁前尖側で28人，後尖側で23人，拡張中期では左室中央に一つの渦流が19人に認められ，心房収縮期の前尖側に19人，後尖側で1人のみに検出された．拡張早期のCirculationは前尖側が後尖側に比べ有意に高値であった（p＜0.001）．また，拡張早期前尖側のCirculationはE波速度，E/A, e′と，後尖側はE波速度，E/A, e′と有意な相関を示した．一方，拡張中期および心房収縮期前尖側はいずれの項目とも有意な相関を認めなかった．若年健常者において拡張期左室内渦流の出現率は時相によって異なり，拡張早期の渦強度は左室弛緩能と関連していた．

結論：VFMで可視化した若年健常者の拡張期左室内渦流は特徴的であり，新たな左室弛緩能評価に応用できる可能性が示唆された．

Purpose: This study investigated the characteristics of diastolic left ventricular vortex in young healthy subjects using vector flow mapping (VFM).

Subjects and Methods: Twenty-eight young healthy adults (16 males, mean age: 22±1 years) were enrolled. Color Doppler loops were acquired for VFM using the apical long-axis view, after which the incidence of left ventricular vortex during diastole and the correlation between the circulation during diastole and echocardiographic parameters were examined.

Results and Discussion: During the early diastole, vortices were detected in 28/28 (100.0%) and 23/28 patients (82.1%) on the anterior and posterior mitral leaflets, respectively. A vortex was observed in 19/28 patients (67.9%) during the mid-diastole in the left ventricle, 19/28 patients (67.9%) on the anterior side, and 1/28 patients (3.6%) on the posterior side during atrial contraction. Circulation in the early diastole was significantly higher on the anterior leaflet than on the posterior leaflet (p＜0.001). Circulation on both mitral leaflets was significantly correlated with E wave velocity, E/A, and e′; however, echocardiographic values showed no significant correlation with circulation in the mid-diastole and atrial contraction phase. In young healthy adults, the incidence of diastolic left ventricular vortices varied according to time phase, and early diastolic vortex intensity was associated with left ventricular relaxation.

Conclusion: Characteristic findings were found for the diastolic left ventricular vortex observed via VFM in healthy young adults. Vortex analysis may be a novel method for evaluating left ventricular relaxation.

Key words: vector flow mapping; vortex; circulation; left ventricular diastolic function

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