多普勒组织成像评价房间隔缺损并肺动脉高压患者右心室收缩功能

DTI evaluation of right ventricular systolic function in atrial septal defect complicated with pulmonary hypertension

目的探讨多普勒组织成像(DTI)技术评价房间隔缺损(ASD)并肺动脉高压患者右心室收缩功能的临床意义.方法 56例ASD并肺动脉高压患者按肺动脉高压程度分为轻、中、重3组,并选取22例健康人作为正常对照组,采用DTI技术取四腔心切面检测所有受检者三尖瓣前叶瓣环收缩期峰值速度(S波)及收缩期峰值加速时间(AC),并进行组间比较.结果 ASD并轻、中度肺动脉高压组S波均高于正常组(P＜0.05或P＜0.01),而重度组S波则低于正常组(P＜0.05).ASD并轻、中及重度肺动脉高压组AC均长于正常组(P＜0.05),且3组间相比也有显著性差异(P＜0.05),并随肺动脉压力增加,明显延长.结论 DTI技术可用于评价ASD并肺动脉高压患者的右心室收缩功能,是一种无创、简便、定量评价右心室收缩功能的新技术.

Objective To explore the significance of Doppler tissue imaging （DTI） in the assessment of right ventricular systolic function in atrial septal defect （ASD） patients complicated with pulmonary hypertension. Methods A total of 56 subjects divided into three groups according to the severity of pulmonary hypertension were analysed. The control group consisted of 22 healthy subjects. On the 2-dimensional echo image of 4-chamber view, PW-DTI was applied to measure the peak systolic annular velocity and systolic acceleration. Results The peak systolic annular velocity in low-grade and medium-grade of pulmonary hypertension group were faster than that of the control group. However the peak systolic annular velocity of the high-grade group was slower than that of the control group. Systolic acceleration in the control group was shorter than those of the pulmonary hypertension groups. Furthermore, the higher the pulmonary hypertension, the longer the systolic acceleration （AC）. Conclusions DTI is the most advantageous method for the noninvasive assessment of the right ventricular systolic function in the disease.