三尖瓣环收缩期位移评价肺动脉高压患者右心室功能的研究

Right Ventricular Function Assessed by Tricuspid Annular Plane Systolic Excurtion in Patients with Pulmonary Arterial Hypertension

目的:应用斑点追踪显像(STI)技术测量三尖瓣环收缩期位移(TAPSE),评价肺动脉高压(PAH)患者右心室的功能。材料和方法:PAH患者57例,按肺动脉收缩压(PASP)程度分为轻度PAH、中度PAH和重度PAH3组,健康体检者28例为对照组,应用STI技术分别测量三尖瓣环间隔部和右心室游离壁部以及此两点连线的中点(TAPSEmid)相对于心尖部的位移,应用频谱多普勒测量肺血管阻力(PVR),分析比较4组间各位移的差异,并与PVR及PASP进行相关性分析。结果:PAH中、重度组的TAPSE均低于对照组及轻度组(P<0.05),重度组低于中度组(P<0.05),轻度组和对照组间无显著性差异(P>0.05);三尖瓣环三个测量部位的位移均与PVR及PASP相关(P<0.001),TAPSEmid与PASP及PVR的相关性最高。结论:收缩期STI测量TAPSE可定量评估PAH患者右心室功能。

Purpose To assess the right ventricular（RV）function in patients with pulmonary arterial hypertension（PAH）by tricuspid annular plane systolic excurtion （TAPSE） measured by speckle tracking imaging（STI）.Materials and Methods Fifty-seven patients with PAH were enrolled and were divided into 3 groups,mild,moderate and severe according to the pulmonary arterial systolic pressure （PASP）.Twenty-eight normal individuals were enrolled as control.The systolic displacements of septum,right ventricular free wall at the the tricuspid annular plane and their mid-point to the apex of RV （TAPSEmid） were measured by STI.Pulmonary vascular resistance（PVR）was also obtained from the Doppler.Results The moderate and severe PAH had significantly lower TAPSE than mild PAH and the control（P〈0.05）,The severe PAH had significantly lower TAPSE than moderate PAH（P〈0.05）,while there were no significant statistical difference between mild PAH and the controls（P〉0.05）.TAPSE measured from the three points were well correlated with PVR and PASP（P〈0.001） and TAPSEmid had the highest correlation with PASP and PVR.Conclusion Systolic STI measurement of TAPSE can be used for quantitative assessment of the right ventricular function of the PAH patients.