实时三维经食管超声心动图对二尖瓣环与左心室功能的相关性研究

The Relationship between Mitral Annulus and Left Ventricular Function on Real-time Three Dimensional Transesophageal Echocardiography

目的应用实时三维经食管超声心动图(RT3DTEE)研究二尖瓣环的形态及功能与左室容积及收缩功能的关系。资料与方法采集28例受试者的三维全容积图像,采用二尖瓣定量分析软件(MVQ)测量二尖瓣环舒张末期(ED期)、收缩末期(ES期)的三维周长(3DC)、三维面积(3DA)及旋转角度;采用三维定量分析软件(3DQ)测量左心室舒张末期容积(EDV)和收缩末期容积(ESV)、每搏量(SV)及射血分数(EF)。结果二尖瓣环在ED期、ES期的3DC、3DA均与EDV、ESV呈正相关(r=0.501～0.631,P<0.01);其3DA在心动周期中减小的绝对值与SV呈正相关(r=0.478,P<0.01);其旋转角度与EF呈正相关(r=0.562,P<0.05)。结论左心室容积是二尖瓣环大小的决定因素,左心室收缩功能决定了二尖瓣环旋转的能力,二尖瓣环从舒张期到收缩期面积的减小与左心室每搏量有关。

Purpose To investigate the relationship between the size and function of mitral annulus （MA） and the volume and systolic function of left ventricle （LV） using real time three dimensional transesophageal echocardiography（RT3DTEE）. Materials and Methods Twenty-eight patients with full volume dataset were analyzed. Three dimensional circumference （3DC）, three dimensional area （3DA） and intercommissure axis rotation in end diastole and end systole of MA were determined using Mitral Valve Quantification （MVQ） software. The end diastolic volume （EDV）, end systolic volume （ESV）, stroke volume （SV） and ejection fraction （EF） of LV were measured using 3DQ software. The relationship between MA and LV was analyzed using SPSS11.5. Results Mitral annular 3DC, 3DA in end diastole and end systole were all positively correlated with EDV and ESV（r=0.501～0.631, P0.01）.The area change of MA in cardiac cycle showed positive correlation with SV（r=0.478,P0.01）. The rotation angle of mitral annular intercommissure axis was positively correlated with EF（r=0.562, P0.05）. Conclusion Left ventr-icular volume is the determinant factor of the MA size. The rotation capability of MA is determined by the LV systolic function. The area change of MA during cardiac cycle is correlated with left ventricular stroke volume.