实时三维超声心动图评价正常儿童左、右心室容积及收缩功能

Evaluation of left and right ventricular volume and systolic function in normal children with RT-3DE

目的应用实时三维超声心动图(RT-3DE)比较正常儿童左、右心室容积及收缩功能。方法以RT-3DE采集192名年龄2个月～13岁8个月正常儿童的左、右心室的全容积数据,并按年龄分为Ⅰ～Ⅴ组。应用TomTec LV-A-nalysis及RV-function软件分析左、右心室舒张末期容积(EDV)、收缩末期容积(ESV),每搏输出量(SV),心室射血分数(EF)及心室容积收缩峰值速率(PSVR),对各年龄组左、右心室上述指标进行比较;同时对EDV与年龄及体格指标进行相关性和曲线估计回归分析。结果各年龄组中,RT-3DE测量左、右心室EDV差异均无统计学意义(P均>0.05),左、右心室ESV、SV及PSVR在部分年龄组中差异无统计学意义(P均>0.05),而左心室EF高于右心室,其在5个年龄组中差异均有统计学意义(P均<0.05)。左、右心室EDV与年龄、身高、体质量、体表面积呈正相关(r均>0.85,P均<0.001),曲线估计回归分析表明其相关性均以幂模式拟合最佳,其中与体表面积拟合的曲线最佳,回归方程分别为左心室EDV=38.58BSA1.41(r2=0.89,P<0.001)、右心室EDV=37.46BSA1.29(r2=0.85,P<0.001)。结论RT-3DE测量正常儿童左、右心室舒张末期容积相近,两侧心室存在泵血功能平衡,心室容积随年龄增长呈指数模式增长。

Objective To evaluate the left and right ventricular volume and systolic function in normal children by full- volume imaging of real-time three dimensional echocardiography （RT-3DE）. Methods The full-volume imaging of left and right ventricle in 192 normal children aged from 2 months to 13 years and 8 months were obtained by RT-3DE. Totally 192 normal children were divided into Ⅰ-Ⅴ groups by age. The left and right ventrieular end-diastolic volume （EDV）, end- systolic volume （ESV）, stroke volume （SV）, ejection fraction （EF）, and the peak systolic volume-rate （PSVR） were ana- lyzed with TomTec LV-analysis and RV-function. The above RT-3DE indexes between left and right ventricles were com- pared among the five age groups. Correlation analysis and curve estimation were performed on biventricular end-diastolic volume with age and physical development indexes. Results In each age group, there was no statistical difference of biven- tricular EDV, while for ESV, SV, PSVR, no significant difference was found in some groups （all P〉0.05）. Left ventricle EF was higher than right ventricle EF （P〈0. 05）. EDV of left and right ventricle had good positive correlation with age, height, weight and body surface area （BSA, r〉0.85, P〈0. 001）. Curve estimation demonstrated that the interrelation between biventricular EDV and age, height, weight, BSA could be best expressed by power model, the best matched model was found with BSA. The regression equation was left ventricle EDV=38.58 BSA^1.41 （r^2 = 0.89, P〈0. 001）, right ventri- cle EDV=37.46 BSA^1.29 （r^2=0.85, P〈0. 001）. Conclusion The biventrieular volumes attained with RT-3DE are similar with each other. There is balance between left and right ventricle pumping function. The ventricular volume increases with age in an exponential mode.