二维斑点追踪技术评价房间隔缺损伴肺动脉高压患者封堵术后的右室功能变化

The value of 2D speckle tracking imaging in assessing right ventricular function of atrial septal defect accompanied with pulmonary hypertension after transcather closure

目的:应用二维斑点追踪技术评价房间隔缺损(ASD)伴肺动脉高压患者封堵术后的右室功能变化。方法:应用二维斑点追踪技术测量伴有不同程度肺动脉高压的30例房间隔缺损患者封堵术前、术后1周的右心室游离壁基底段、中间段收缩峰值应变(￡)、收缩峰值应变率(SRs)、舒张早期峰值应变率(SRe)、舒张晚期峰值应变率(SRa),二维超声测量各房室腔大小。31例年龄、性别匹配的正常人作为对照。结果:ASD组患者基底段、中间段的￡、SRs、SRe、SRa均低于正常对照组,差异具有统计学意义(P<0.05);ASD患者术后1周较术前检查,基底段、中间段￡、SRs、SRe、SRa值明显增加,差异具有统计学意义(P<0.05),ASD患者术后1周与术前比较,右心房(RA)、右心室(RV)及肺动脉收缩压(PASP)明显减小,差异有统计学意义(P<0.05)。结论:伴有肺动脉高压的ASD患者表现为合并不同程度的右心室功能降低。ASD患者在封堵术后短期内,其右心室功能得到改善。二维斑点追踪技术可准确、客观地检测、评价ASD术后右心室功能的变化。

Objective： To evaluate right ventricular function of patients with atrial septal defect（ASD） and pulmonary hypertension by 2D speckle tracking imaging（STI）.Methods： Peak systolic strain（￡）,peak systolic strain rate（SRs）,early diastolic strain rate（SRe） and late diastolic strain rate（SRa） were measured in basal and mid segment of right ventricular free wall in 30 patients of ASD with pulmonary hypertension before surgery and a week after surgery by STI from the apical 4-chamber view.The chamber size was measured by two-dimensional ultrasound in 31 healthy subjects as controls.Results： It was showed that the ￡,SRs,SRe and SRa in basal and mid segment of right ventricular free wall in the ASD group were significantly lower than those in the control group.In the ASD group,a week after transcatheter closure,RA,RV and PASP decreased,while ￡,SRs,SRe and SRa increased in basal and mid segment of the right ventricular free wall.Conclusions： The right ventricular function of the ASD patients with pulmonary hypertension degraded in different degrees.The right ventricular function is improved significantly after transcatheter closure.Right ventricular function can be accurately and objectively evaluated by STI.