Tei指数评价房间隔缺损无并发肺高压患者的右室功能

Evaluation of Right Ventricular Function by the Tei Index in Patients with Atrial Septal Defect without Complication of Pulmonary Hypertension

目的探讨组织多普勒(TDI)Tei指数评价房间隔缺损(ASD)无并发肺动脉高压患者右室功能的改变。方法选取2012年3月-10月无并发肺动脉高压的继发孔型房间隔缺损患者31例(ASD组)及健康体检者30例(对照组),应用TDI成像获取三尖瓣环运动频谱,测定频谱图上Aa峰至S峰的时间(等容收缩时间,ICT),S峰的持续时间(射血时间,ET)和S峰至Ea峰的时间(等容舒张时间,IRT),计算右室Tei指数。房缺组Tei指数及相关参数与缺损大小和患者年龄作相关性研究。结果 ASD损无并发肺动脉高压患者右室等容收缩时间(ICT)低于正常对照[(45±7)、(59±8)ms,P<0.001],右室等容舒张时间(IRT)高于正常对照[(85±5)、(78±14)ms,P<0.01],房缺组Tei指数低于正常对照(0.48±0.03、0.52±0.05,P<0.001)。房缺组的缺损大小与Tei指数、ICT呈负相关(r=-0.61,P<0.01;r=-0.44,P<0.05),而患者年龄与Tei指数、ICT及IRT呈正相关(r=0.69,P<0.001;r=0.75,P<0.001;r=0.63,P<0.001)。结论 TDI Tei指数是无创、有效和快捷评价右室功能的方法;ASD无并发肺动脉高压患者的ICT缩短,Tei指数减低,右室收缩和整体功能增强,而IRT延长,舒张功能受损;缺损越大,右室收缩和整体功能越强;年龄越大,右室整体功能相对减低。

Objective To investigate the changes of right ventricular（RV） function by tissue doppler imaging Tei index in patients with atrial septal defect（ASD） without complication of pulmonary hypertension.Methods Thirty-one patients with secundum ASD diagnosed between March and October 2012 and 30 age-matched controls were included in our study.Tissue doppler imaging was performed in all subjects to get tricuspid valve ring movement curve.Aa to S peak time（Isovolumetric Contraction Time,ICT）,S peak duration（Ejection Time,ET）,and S to Ea peak time（Isovolumetric Relaxation Time,IRT） were measured,and then we calculated right ventricular Tei index.Further correlative analysis was performed between right ventricular Tei index,and ASD size and patients＇ age.Results ICT of the ASD group was significantly lower than that of the normal controls（45 ± 7 ms vs 59 ± 8 ms,P0.001）,while IRT was significantly higher（85 ± 5 ms vs 78 ± 14 ms,P〈0.01）.Right ventricular Tei index of the ASD patients was significantly lower than that of the normal controls（0.48 ± 0.03 vs 0.52 ± 0.05,P0.001）.The ASD size had negative correlation with right ventricular Tei index and ICT（r=-0.61,P〈0.01;r=-0.44,P〈0.05）.Patients＇ age had positive relation with right ventricular Tei index,ICT and IRT（r=0.69,P0.001;r=0.75,P0.001;r=0.63,P0.001）.Conclusions Tissue doppler imaging Tei index may be a fast and convenient new technology to evaluate RV function.For patients with ASD but without complication of pulmonary hypertension,ICT is short and Tei index is lower,which indicates the improvements of right ventricular systolic and overall function,while longer IRT reflects impairment of right ventricular diastolic function.Right ventricular systolic and overall function increase with ASD size,and RV function is relatively lower in patient of old age.