多普勒超声心动图评价房间隔缺损封堵后右心形态及功能的变化

Evaluation of morphological and functional changes of right heart after closure of atrial septal defect and follow-ups by Doppler echocardiography

目的利用多普勒超声心动图评价房间隔缺损(ASD)封堵后右心形态及功能的变化。方法对41例Ⅱ孔型房缺患者术后2d、3个月和6个月行TTE检查。应用AQ技术测量右室收缩末期容积、舒张末期容积,每搏量,射血分数,峰值充盈率和峰值排空率;同时测量右房面积和面积变化率;利用多普勒频谱分析肺动脉瓣口血流频谱。结果术后2d,除峰值排空率外右室各指标均减小,右房指标未见显著变化。3个月随访上述指标除射血分数外均进一步减小,右房面积缩小,差异有显著性(P<0.05)。与3个月相比,6个月时右心房室各指标均差异无显著性(P>0.05)。肺动脉频谱指标也提示右心室收缩功能的减弱。结论封堵后右心的形态及功能较术前恢复正常。

Objective Evaluating morphological and functional changes of right heart after closure of atrial septal defect and follow-up by doppler echocardiography. Methods Forty-one patients with secondum-type ASD under-went transcameter closure, echocardiography examinations were taken in2 days, 3 months and 6 months atter closures. End-systolic volume （ ESV ）, end-diastolic volume （ EDV ）, stroke volume （ SV ）, ejection fraction （ EF）, peak filling rate（PFR） ,peak ejecting rate （PER） of right ventricle were measured by acoustic quantification （AQ）, so as the end-systolic area（ ESA）, end-diastolic area （EDA） and the fraction of area＇s change um. Meanwhile, Blood-stream＇s spectrum were analyzed at pulmonary valve orifices. Results （FAC） of right atri- 2 days after closure, all the indexes of right ventricle except PER diminished significantly （P 〈 0. 05 ）. In 3 months, all the indexes except RVEF declined significantly compared to 2 days. Indexes of right atrium except FAC declined significantly from 3 months on（P 〈0. 05 ）. All the AQ indexes of 6 month follow-up showed no significant changes compared to 3 months （ P 〉 0. 05 ）. The changes of indexes of pulmonary spectrum showed decays of the systolic function of right ventricular. Conclusion ASD closure can improve the high-volume load of the right heart and recover the systolic function of the right heart.