组织运动瓣环位移自动追踪技术评价房间隔缺损患者封堵术前后右心室功能的变化

Evaluation of right ventricular function before and after transcatheter closure in patients with atrial septal defect by tissue motion annular displacement

目的应用组织运动瓣环位移自动追踪技术(TMAD)测定三尖瓣环位移(TAD)评价房间隔缺损(ASD)患者介入封堵术前后右心室收缩功能的变化。方法研究对象为25例成功进行介入封堵的伴肺动脉高压的继发孔型ASD患者,分别于术前、术后3 d、术后1个月、术后3个月、术后6个月行超声检查,测量右心室前后径(RV)、右心房左右径(RA)、主肺动脉内径(MPA)、肺动脉收缩压(PASP);应用TMAD技术测量各时间点三尖瓣环右心室游离壁处、室间隔处及二者连线中点处相对于右心室心尖部的收缩期峰值位移(T1、T2、Tm),并对测量结果进行分析比较。结果与术前相比,术后不同时间点RA、RV、MPA、PASP逐渐减小,差异有统计学意义(P<0.05);术后不同时间点T1、Tm较术前逐渐增大,差异有统计学意义(P<0.05)。结论 ASD患者经介入封堵治疗,既改善了右心系统的几何结构,又改善了右心室收缩功能。

Objective To evaluate the change of the right ventricular function with tricuspid annular displacement （ TAD） measured by tissue motion annular displacement （ TMAD） in patients before and after atrial septal defect （ ASD ） transcatheter closure .Methods Transcatheter closure of ASD with pulmonary hypertension was performed in twenty-five patients.Echocardiography was done before the closure ,and three-days,one-month,three-months,six-months after the closure.The inner diameter of right atrium （ RA）, right ventricular （ RV）, main pulmonary artery（MPA）and pulmonary arterial systolic pressure （PASP）were measured.The TAD of different period at right ventricular free wall,septum and the mid-point（recorded as T1,T2 and Tm respectively）were measured by TMAD technique .Results The RA,RV,MPA and PASP of the different periods after the operation were decreased gradually compared with that before the closure , and the difference was significant （ P〈0.05 ） .T1 and Tm of the different periods after closure increased gradually compared with that before closure , and the difference was also significant （ P〈0.05 ） .Conclusion The transcatheter closure treatment not only improve the geometry structure of the right heart ,but also improve the function of the right ventricle in patients with ASD .