心脏移植术后左右心室功能变化的临床价值

Echocardiographic parameters for assessing left and right ventricular function after heart transplantation

目的探讨心脏移植术后左右心室收缩及舒张功能的变化的临床价值。方法2000年8月至2007年6月在复旦大学附属中山医院行心脏移植后随访的患者20例,行常规超声检查;应用脉冲多普勒记录二尖瓣、主动脉瓣、三尖瓣、肺动脉瓣血流图;组织多普勒记录心尖四腔心切面图谱;实时三维超声心动图测量左心室射血分数。并与正常对照组进行比较。结果心脏移植组左房内径较正常对照组明显增大(P<0.01),右室的Tei指数较正常对照组高(P<0.05)。三尖瓣口血流图心脏移植组A峰的峰值速度较正常对照组高(P<0.01),E/A比值心脏移植组较正常对照组低(P<0.05);三尖瓣瓣环右室侧壁的收缩速度、E峰的峰值速度、A峰的峰值速度均较正常对照组低(P<0.01,P<0.05,P<0.05),E/A比值较正常对照组高(P<0.05);右室侧壁的收缩速度、E峰的峰值速度、A峰的峰值速度均较正常对照组低(P均<0.05),E/A比值较正常对照组高(P<0.05)。结论心脏移植组其右室收缩功能减退,而左室收缩功能及左右室舒张功能未见明显异常。

Objective To investigate the value of left and right function variety after heart transplantation. Methods Twenty heart transplants were studied on two-dimensional echoeardiography, pulsed wave Doppler, tissue Doppler and three-dimensional eehocardiography. Results Left atrial diameter in heart transplants was enlarger than normal subjects （P 〈 0. 01 ） , fight ventricular Tel index, velocity of peak A in tricuspid were higher than those of the normal subjects （ P 〈 0.05, P 〈 0. 01, respectively）, the ratio of E/A in tricuspid was lower than that of the normal subjects（ P 〈 0.05 ）, systolic velocity in tricuspid annulus and right ventrieular wall, velocity of peak E and peak A were reduced significantly compared with the normal subjects（P 〈 0. 01, P 〈 0. 05, P 〈 0. 05, respectively） , while the ratio of E/A was increased significantly compared with the normal subjects （ P 〈 0. 05 ）. Conclusions Right ventricular systolic function is reduced in heart transplant.