斑点追踪显像检测三尖瓣环位移评估右心室收缩功能的应用价值

Evaluation of right ventricular systolic function using two-dimensional speckle tracking of tricuspid annular displacement

目的探讨超声二维斑点追踪显像技术测定三尖瓣环位移（tricuspid annular displacement，TAD）在评估右室收缩功能方面的应用价值。方法研究对象为扩张型心肌病患者18例，20例年龄相匹配的健康志愿者作对照组。取心尖四腔观采集二维和实时三维图像，然后将二维图像输入QLAB6．2工作站获取三尖瓣环中点收缩期位移等参数，将实时三维图像输入TomTec工作站，用四维右室功能分析（4DRVF）软件计算右室射血分数（RVEF）。结果38例全部获得TAD值，30例得到RVEF数据。TAD各测值和RVEF之间相关性良好（P〈0．01），扩张型心肌病患者TAD各测值均显著低于健康对照组（P〈0．01）。TAD在观察者间及观察者内的差异分别为（0．49±2．69）mm及（0．21±0．60）mm。结论二维斑点追踪显像检测TAD能客观反映右室的收缩情况，有望成为临床评价右室收缩功能的一项新指标。

Objective To determine the usefulness of tricuspid annular displacement （TAD） ,based on twodimensional speckle tracking imaging, for assessment of right ventricular （RV） systolic function. Methods Eighteen patientswith dilated cardiomyopathy and 20 age matched healthy volunteers were in volved. Twodimensional and real-time tbree-dimensional（RT3D） imaging were obtained in all patients at apical four-chamber view. The parameters of TAD were derived from off line QLAB software. RT3D-RV ejection fraction（RVEF） was calculated by using 4D RV function software. Results TAD data were acquired in all 38 cases,while RT3D-RVEF was done in 30 out of 38. The parameters of TAD correlated well with RVEF （ P 〈0. 01 ）. The parameters of TAD in dilated cardiomyopathy group were significantly lower than the corresponding values in healthy subjects （ P 〈0. 01 ）. The intra and interobserver variabilities for measurement of TAD were （0.49 ± 2.69） mm and （0.21 ± 0.60） mm, respectively. Conclusions TAD, based on two-dimensional speckle tracking imaging, proved to be a rapid and reproducible method in determining RV global systolic function.