超声心动图评价室间隔缺损封堵术后左心功能及形态的变化

Changes of Left Cardiac Function and Morphology After Transcatheter Closure of Ventricular Septal Defect Evaluated by Echocardiography

目的探讨超声心动图对室间隔缺损封堵术后左心功能及形态变化的评价作用。方法60例接受Amplatzer封堵器封堵治疗的室间隔缺损患者,于术前1天、术后3天、3月及6月行经胸超声心动图检查,测量左心室舒张期末内径、左心室舒张期末容积、左心室收缩期末容积、左心房收缩期末内径、左心室射血分数、左心室侧壁基底部组织收缩期运动速度、舒张早期运动速度及舒张晚期运动速度。结果室间隔缺损封堵术后3月、6月左心室舒张期末内径、左心室舒张期末容积、左心室收缩期末容积、左心房收缩期末内径、左心室射血分数、左心室侧壁基底部组织收缩期运动速度、舒张早期运动速度及舒张晚期运动速度均较术前1天及术后3天明显减少(P<0.05或0.01),但术后3天与术前1天比较差异无显著性(P>0.05)。结论室间隔缺损封堵术在消除异常分流的同时,可有效改善左心功能及几何形态。

Aim To evaluate left cardiac function and morphology in patients with ventricular septal defect （ VSD ）after transcatheter closure by eehocardiography. Methods In 60 patients with transcatheter closure of VSD by Amplatzer occluder, echocardiography examinations were performed to calculate left ventricular end-diastolic diameter （ LVEDD ） , left ventrieular end-diastolic volume （LVEDV） left ventricular end-systolic volume （ LVESV ） , left atrium end-systolic diameter （ LAESD） , left ventrieular ejection fraction （LVEF） , systolic movement velocities （ S＇ ） , early diastolic movement velocities （ E＇ ） and late diastolic movement velocities （ L＇ ） 1 day before, 3 days, 3 months and 6 months after the closure respectively. Results LVEDD, LVEDV, LVESV, LAESD, LVEF, S＇, E＇ and L＇ of 3 and 6 months after transcatheter closure were lower than those of 1 day before transcatheter closure and 3 days after transcatheter closure （ P 〈 0.05 or 0.01 ）. There were no difference between 3 days after transeatheter closure and 1 day before transeatheter closure （ P 〉 0.05 }. Conclusion Transcatheter closure of VSD can improve left cardiac function and geometric morphology, at the same time it can eliminate the abnormal shunt.