单心动周期实时三维超声心动图评价健康成人右心室容积和射血分数

Assessment of right ventricular volumes and ejection fraction in healthy adults by single-beat real-time three-dimensional echocardiography

目的采用单心动周期实时三维超声心动图（sRT-3DE）测量健康成人右室容积和射血分数，探讨其正常参考值范围及变化规律。方法选取334例健康成人，按性别分为男性组和女性组，按年龄分为6个组。应用sRT-3DE测量不同性别及年龄组健康成人右室容积和射血分数，对右室容积参数用体表面积（BSA）和瘦体重（LBM）标化，统计分析得到上述参数正常值范围，并研究其在性别间的差异以及与体型特征（身高、体质量、体质指数、BSA、LBM）的相关性。结果348例健康成人中334例（96％）完成sRT-3DE检查，标化前男性组右室舒张末容积（RVEDV）、右室收缩末容积（RVESV）、右室每搏输出量（RVSV）大于女性组，差异具有统计学意义（P〈0．001），两组间右室射血分数（RVEF）差异无统计学意义（P〉0．05）；LBM标化后男性组RVEDV、RVESV、RVSV小于女性组，差异具有统计学意义（P〈0．001）；不同年龄组RVEDV、RVESV、RVSV差异具有统计学意义（P〈0．05），而RVEF差异无统计学意义（P〉0．05）；RVEDV、RVESV、RVSV均与身高、体质量、体质指数、BSA及LBM呈正相关，与年龄呈负相关；RVEF与以上因素均无相关性。结论本研究采用sRT-3DE初步提供了不同性别及年龄组健康成人右室容积和射血分数的正常参考范围，并发现LBM在成人心脏结构中有一定影响，为临床右心疾病的诊疗提供有价值的依据。

Objective To analyze the normal reference values of the right ventricular volumes and ejection fraction of healthy adults measured by single-beat real-time three-dimensional echocardiography （sRT-3DE）. Methods The subjects of this study included three hundred and thirty-four healthy adults,and were divided into 2 groups by gender and 6 groups by age. The sRT-3DE was chosen to measure their right ventricular volumes and ejection fraction. The parameters of right ventricular volumes were standardized by body surface area （BSA） and lean body mass （LBM） to calculate the ranges of their normal value. The correlation between these parameters and genders as well as the physical characteristics （height, weight, body mass index,BSA and LBM） was also clarified. Results Three hundred and thirty-four （96%） of the 348 subjects had been tested. Before standardizing, men had larger right ventricular volumes compared with women,and the differences of the right ventricular end diastolic volume （RVEDV）, right ventricular end systolic volume （RVESV） and right ventricle stroke volume （RVSV） were statistically significant（ P 〈0.001）, but it had no statistical significance in the difference of the right ventricular ejection fraction （RVEF）（ P 〉0.05）. After standardizing by LBM,the RVEDV,RVESV and RVSV in male group were significantly lower than those in women group （P 〈0.001）. In different age groups, the difference of RVEDV,RVESV, RVSV , but no RVEF were statistically significant（ P 〈0.05）. Positive correlations between the RVEDV, RVESV, RVSV and the BSA, height, weight, body mass index and LBM had been detected,and it showed a negative relation between RVEDV,RVESV, RVSV with age. Noticeably,RVEF had no correlation with them. Conclusions sRT-3DE can provide a preliminary range for normal reference values of right ventricular volumes and RVEF in healthy adults according to gender and age and finds that LBM has certain impact on adult cardiac structure,which offers valuable evidence for the diagnosis of right heart diseases in clinical practices.