实时三维超声心动图评价正常人右心室节段容积和收缩功能的研究

Evaluation of right ventricular regional volume and systolic function in normal adults using real-time three-dimensional echocardiography

目的运用实时三维超声心动图(RT3DE)方法分析正常人右心室节段容积和收缩功能。方法应用PHILIPS-iE33超声显像仪及匹配的X3-1探头对53名正常成年人进行常规超声心动图及RT3DE检查。应用TomTec软件定量分析右心室RT3DE图像,获得右心室整体及流入道、体部和流出道三个节段的舒张末容积(EDV)、收缩末容积(ESV)、每搏输出量(SV)、射血分数(EF),计算各节段容积达最小值时间(Tmsv)及其所占心动周期的百分率(Tmsv%)的标准差(SD)和最大差(dif)作为右心室收缩同步性参数。结果正常人男性组右心室体部、流出道及整体EDV及SV大于女性组(P均<0.05),其右心室三个节段及整体ESV均大于女性组(P均<0.05),流入道EF略低于女性组(P<0.05)。组内比较结果显示,正常人右心室流入道EDV和SV均大于流出道和体部(P均<0.05),节段EF值大小关系均为流入道>流出道>体部(P均<0.05),整体和三个节段Tmsv及Tmsv%之间均无显著差异。相关性分析结果显示,正常人右心室整体EDV与右心室舒张末期内径及面积呈正相关(P均<0.05),右心室整体ESV与右心室收缩末期内径及面积呈正相关(P均<0.05)。结论正常人右心室三个节段容积和收缩功能具有不同的特点,男性和女性右心室整体和节段容积及收缩功能存在差异,右心室节段收缩活动具有较高的同步性,RT3DE分析右心室节段容积和收缩功能具有潜在的应用价值。

Objective To explore the characteristics of right ventricular(RV)regional volume and systolic function in normal adults using real-time three-dimensional echocardiography(RT3DE).Methods RT3DE images were acquired from 53 normal adults for evaluation and analysis to obtain RV global and regional end-diastolic volume(EDV),end-systolic volume(ESV),systolic volume(SV)and ejection fraction(EF)in three compartments(inflow,body and outflow).The RV dyssynchrony parameters were calculated as the standard deviation(SD)and maximum difference(dif)of time to minimum systolic volume(Tmsv)and Tmsv corrected by heart rate(Tmsv%)in three RV compartments.Conventional echocardiographic parameters were calculated and recorded.Results Higher RV global and regional(body and outflow)EDV and SV,higher global and regional ESV and lower inflow EF were found in the male group when compared with the female group(all P<0.05).It was found that EDV and SV in the inflow compartment were the highest in the three compartments of the right ventricle(all P<0.05),and the difference of regional EF were ordered from larger to smaller as inflow>outflow>body(all P<0.05).The differences among global and regional Tmsv and Tmsv% were not significant.RV global EDV was positively correlated with RV end-diastolic diameters and area(all P<0.05).RV global ESV was positively correlated with RV end-systolic diameters and area(all P<0.05).Conclusions In normal adults,there were distinct characters of regional volume and systolic function in the three compartments of the right ventricle,with high systolic synchronicity and certain differences between males and females.RT3DE may play a potential role in the evaluation of RV regional volume and systolic function.