房间隔缺损患者右室局部容积与功能的实时三维超声评价

Assessment of regional right ventricular volume and function in atrial septal defect patients by real time three-dimensional echocardiography

目的应用实时三维超声心动图(RT3DE)技术评价房间隔缺损(ASD)患者右室局部容积与功能。方法对36例ASD患者行三维容积成像,应用4D RVQ测量以下诸参数,右室局部容积各指标包括右室流入道部、流出道部、心尖肌小梁部舒张/收缩末期容积(iRVEDV、oRVEDV、aRVEDV/iRVESV、oRVESV、aRVESV),整体舒张/收缩末期容积(gRV-EDV/gRVESV)及相应的局部/整体射血分数(iRVEF、oRVEF、aRVEF/gRVEF),并比较各局部容积和局部射血分数;将LA8-plane法与4D RVQ测量的整体右室容积及射血分数行相关分析。结果4DRVQ法与LA8-plane法测量的gRV-EDV、gRVESV及gRVEF相关良好,r值分别为0.94、0.92及0.80。ASD患者局部收缩、舒张末期容积测值以右室流出道部为低,心尖部射血分数明显低于右室流出道部、流入道部及整体射血分数测值,差异有统计学意义(P<0.05)。结论RT3DE可准确评价ASD患者右室整体及局部容积与功能,且各右室局部收缩功能之间存在差异,整体收缩功能尚未出现变化时,心尖肌小梁部出现早期收缩功能损害。

Objective Assessment of regional right ventricular volume and function in atrial septal defect （ASD） patients using real time three-dimensional echocardiography （RT3DE）. Methods RT3DE were performed in 36 ASD patients. Global right ventricular end diastolic/systolic volume （gRVEDV/gRVESV）, regional right ventricular end diastolic/systolic volume including inflow tract component （iRVEDV/iRVESV）, outflow tract component （oRVEDV /oRVESV）, apical component （aRVEDV/aRVESV）, global right ventricular ejection fraction （gRVEF） and regional right ventricular ejection fraction including three components which mentions above （iRVEF, oRVEF, aRVEF）, were measured by 4D RVQ method. The regional RV parameters in different components were compared respectively. The global parameters derived from 4D RVQ were compared with longitudinal axial 8 plane （LA 8-plane） measurements. Results gRVEDV, gRVESV and gRVEF obtained from 4D RVQ method have an excellent correlation with LA 8-plane findings, r= 0. 94, 0.92 and 0.80. The outflow tract component volume was lower than other components and oRVEF was marked decreased （P〈0. 001）. Conclusion RT3DE can evaluate ASD patients＇ global and regional right ventricular volume and function accurately, the systolic function is difference to each regional right ventricular and the systolic function of apical component has earlier lesion.