二维超声心动图及组织多普勒检测房间隔缺损封堵术前后右心负荷的变化

Changes in right heart load detected by two-dimensional echocardio graghy and tissue Doppler imaging before and after atrial septal defect occlusion

目的 :探讨房间隔缺损 (ASD)封堵术对右心负荷改善的作用以及超声心动图检测价值。方法 :应用超声心动图对 46例经心导管 ASD封堵术患者的术前及术后右心负荷变化情况进行检测。二维超声心动图测量右心房及右心室大小 ,组织多普勒测量右室基底部和中部收缩期运动速度 (S' )、舒张早期运动速度 (E' )及舒张晚期运动速度(A' )。结果 :本组患者超声测量 ASD直径为 8～ 3 6(2 4± 7) mm,置入 Amplatzer封堵器大小为 12～ 40 (2 8± 7) mm。右房横径和长径、右室前后径、横径和长径以及右室横截面积术后 48h和 3月比术前明显减小 (均 P<0 .0 1)。右室侧壁基底部及右室侧壁中部组织运动速度术后 48h和 3月比术前明显降低 (均 P<0 .0 1)。结论 :ASD封堵术后右心负荷明显减轻 。

AIM: To investigate the effect of atrial septal defect ( ASD) occlusion on the improvement of right heart load. METHODS: Changes in right heart load in 46 patients with trans-catheter ASD occlusion were detected by echocardio gr aghy before and after the occlusion. The sizes of right atrium and right ventric le w ere measured by two-dimensional echocardiograghy. The systolic movement v elocities(S'), early diastolic movement velocities(E') and late diastolic moveme nt velocities(A') of basic lateral and middle lateral walls of right ventricle w ere measured by tissue Doppler imaging. RESULTS: ASD size measu red by ech ocardiograghy was 8~36(24±7)mm,and size of used Amplatzer occluder was 1 2~40(28±7)mm. The transverse diameter and long diameter of right atrium, and anterior-posterior diameter, transverse diameter, long diameter and cross s e ction area of right ventricle were significantly lessened at 48 h and 3 months a fter occlusion, compared with those before the occlusion(P<0.01). The tissue mo vement velocities of basic lateral and middle lateral walls of the right ventric le w ere obviously reduced 48 h and 3 months after occlusion,compared with those bef or e occlusion(P<0.01). CONCLUSION: The load of the right heart was m arkedly abated after ASD occlusion,which could be detected by two-dimens ional echoca rdiograghy and tissue Doppler imaging.