超声心动图对马凡氏综合征患者的右心室收缩功能的评价

Right ventricular systolic function assessed by echocardiography in patients with Marfan syndrome

目的用超声心动图评价成年马凡氏综合征(Marfan syndrome,MFS)患者是否存在右心室收缩功能不全。方法41例MFS患者及43例正常对照者行M型、二维及组织多普勒超声心动图,记录三尖瓣环收缩期位移(tricuspid annular plane systolic excursion,TAPSE)、右心室面积缩小率(fractional area change,FAC)及组织多普勒三尖瓣环收缩速度(Sta)。结果MFS患者右心室收缩功能指标虽处于正常范围,但均低于正常对照[TAPSE:(21±2)mm vs.(26±1)mm,P<0.01;FAC:36%±2%vs.42%±3%,P<0.01;Sta:(12±0.3)cm/s vs.(16±0.9)cm/s,P<0.01]。结论MFS患者存在右心室收缩功能不全,提示MFS可能累及右心室心肌。

Objectives To investigate right ventricular systolic function in adult patients with Marfan syndrome （MFS） by echocardiography. Methods Of 41 patients with MFS and 43 controls, tricuspid annular plane systolic excursion （TAPSE）, right ventricular fractional area change （FAC） and tricuspid annulus tissue-Doppler imaging （TDI） peak systolic velocities （Sta） were studied using M-mode, two-dimensional, and TDI echocardiography respectively. Results TAPSE, FAC and Sta were significantly reduced in MFS patients when compared with those in controls [TAPSE： （21± 2） mm vs. （26-＋1） mm, P〈0.01; FAC： 36%±2% vs. 42%±3%, P〈0.01; Sta： （12±0.3） cm/s vs. （16±0.9） cm/s, P〈0.011, although they were within the normal range. Conclusions Right ventricular systolic dysfunction exists in patients with MFS, which indicates primary myocardial impairment.