超声斑点追踪成像技术评价房间隔缺损患者介入封堵术前后的右心室功能

Evaluation of right ventricular function in patients with atrial septal defect before and after interventional occlusion using two-dimensional speckle tracking echocardiography

目的应用超声斑点追踪技术(STE)评价房间隔缺损(ASD)患者介入封堵术前后右心室功能改变情况及手术效果。方法应用超声斑点追踪成像技术(STE)测量30例房间隔缺损(ASD)患者应用Amplatzer封堵器介入封堵前(术前组)后(术后组)及32例正常人(对照组)的右室游离壁基底段、中间段、心尖段二维应变(S)、应变率(SR)及位移(D),对结果进行组间比较。结果①ASD患者收缩期右室游离壁各段心肌D减低(P<0.05);ASD患者右室各段心肌S减低(P<0.05)。ASD患者右室各段心肌SRs、SRe减低(P<0.05)。SRa与正常人无明显差异。②ASD患者介入封堵术后右室游离壁基底段、中间段、心尖段二维应变(S)、应变率(SR)及位移(D)均较术前组增高(P<0.05)。结论 ASD患者右心室功能显著减低,ASD患者介入封堵术后右心室功能较术前明显改善,超声斑点追踪成像技术可准确、客观地评价ASD患者介入封堵术前后右心室功能,从而评估手术效果及预后。

Objective To evaluate the function of the right ventricular using two-dimensional speckle tracking echocardiography（STE） in patients with atrial septal defect（ASD） before and after interventional occlusion and interventional effect.Methods Study population consisted of 30 patients with ASD and 32 healthy subjects.Peak systolic strain rate,displacement and peak strain rate in early disastole and during atrial contraction of right ventricular free wall were measured using speckle tracking echocardiography.Results Peak systolic strain rate,displacement and diastolic strain rate of all segment in right ventricular free wall reduced significantly in ASD patients（P〈0.05）,but strain rate in atrial contraction phase of all segments didn’t decrease compared with that in the control group（P〉0.05）.Peak systolic strain,strain rate,displacement and diastolic strain rate of all segment in right ventricular free wall increased significantly in ASD patients after interventional occlusion（P〈0.05）.Conclusions The right ventricular functions have decreased in patients with ASD and significantly improved after interventional occlusion.STE can readily obtain parameters and provide unique data about right ventricular function.