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  • Title: [Visualization of right atrial flow patterns and quantification of pulmonary to systemic flow ratio in patients with atrial septal defect by vector flow mapping].
    Author: Wei X, Tang H, Chen L, Zhang JQ, Li C, Feng Y, Zhou WX, Peng Y, Huang H, Liang YJ, Zhu W.
    Journal: Sichuan Da Xue Xue Bao Yi Xue Ban; 2012 Mar; 43(2):275-9. PubMed ID: 22650048.
    Abstract:
    OBJECTIVE: To evaluate the ability of vector flow mapping (VFM) in visualizing right atrial flow and quantifying pulmonary to systemic flow ratio in patients with atrial septal defect (ASD). METHODS: VFM was performed on 30 patients with ASD and 50 healthy volunteers. The pulmonary to systemic flow ratio (Qp/Qs) was calculated using VFM and spectral doppler compared with that obtained through oximetric data derived from cardiac catheterization. RESULTS: Blood streams from superior and inferior caval veins did not collide but turned forward, contributing to a forward clockwise vortex during systole on the subcostal bi-atrial plane in the healthy volunteers. The vortex was disrupted continuously by a left to right shunt in the patients with ASD during the hole cardiac cycle. The Qp/Qs measured by VFM was less angle-dependent in all the cases than the other methods. The mean value of Qp/Qs of the healthy volunteers calculated by apical three-chamber view and apical five-chamber view ranged from 0.84:1 to 1.15:1, which is consistent with the theoretical value 1 of no left to right shunts. The values of Qp/Qs of patients with ASD measured by VFM and spectral doppler showed no significant differences with those obtained through oximetric data [(2.18 +/- 0.48) vs. (2.29 +/- 0.76), P = 0.29; (2.30 +/- 0.91) vs. (2.29 +/- 0.76), P = 0.86]. However, the Qp/Qs value measured by VFM had a better correlation with the oximetric data than that measured by spectral doppler (r = 0.71, P < 0.001 vs. r = 0.38, P < 0.05). The inter-observer and intraobserver variability of Qp/Qs measured by VFM was 9.84% and 9.86% respectively. CONCLUSION: VFM can visualize right atrial flow field in patients with ASD and quantify Qp/Qs in a more accurate way than spectral dopler.
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