斑点追踪成像测量三尖瓣环位移评价尿毒症患者右心室功能

Tricuspid annular displacement measured with speckle tracking imaging for evaluation on right ventricular systolic function in patients with uremia

目的应用超声二维斑点追踪成像(2D-STI)技术测量尿毒症患者的三尖瓣环收缩期位移(TAD),探讨其评价右心室收缩功能的可行性。方法收集尿毒症患者30例(尿毒症组),选择同期健康人30名作为对照组。记录心尖四腔心二维图像并输入QLab 8.1工作站,测量右心室纵向应变以及TAD软件测量右心室游离壁三尖瓣环收缩期位移(T1)、三尖瓣环中点收缩期位移(Tm)、右心室长轴缩短率(Tm%);比较两组TAD参数的差异,并分析右心室纵向应变与TAD各参数的相关性。结果尿毒症组与对照组间年龄、性别构成比、左心室内径及左心室射血分数差异均无统计学意义(P>0.05)。尿毒症组T1、Tm、Tm%均显著低于对照组(P均<0.01)。T1、Tm、Tm%与右心室纵向应变均呈高度正相关(r=0.79、0.87、0.92,P均<0.01)。结论应用2D-STI测定的TAD与右心室壁纵向应变存在良好相关性,有望成为评价右心室收缩功能的新方法。

Objective To evaluate the feasibility of tricuspid annular displacement （TAD） with two-dimensional speckle tracking imaging （2D-STI） technique in assessment of right ventricular systolic function in patients with uremia. Methods Thirty patients with uremia （uremia group） and 30 healthy volunteers （control group） were enrolled. Two-dimensional imaging were obtained all at the apical four-chamber view. TAD parameters including TAD at the right ventricular free wall （T1）, TAD at the midpoint of tricuspid annulus （Tm） and the right ventricular longitudinal shortening （Tm%） were obtained using off-line QLab 8.1 software. The correlation between right ventricular strain and TAD was analyzed, and the parameters of TAD for two groups were compared. Results The difference in the age, composition ratio of gender, left ventricular inner diameter and left ventricular ejection fraction had no statistical significance between uremia group and normal control group （P〉0.05）. Compared with control group, parameters of T1, Tm, Tm% in uremia group significantly decreased （P〈0.01）. There was close correlation between parameters of T1, Tm, Tm% and the right ventricular strain （r=0.79, 0.87, 0.92, all P〈0.01）. Conclusion TAD measured by 2D-STI shows excellent correlation with right ventricular strain, which may become a new promising method for routine evaluation on right ventricular systolic function.