实时三维超声心动图评价右冠状动脉病变患者右心室局部与整体容积及收缩功能变化

Evaluation of right ventricular regional and global volume and systolic function in patients with right coronary artery disease by real-time three-dimensional echocardiography

目的应用实时三维超声心动图（RT-3DE）评价右冠状动脉病变右室局部与整体容积及收缩功能变化。方法对20例正常对照者（A组）、30例右冠状动脉狭窄患者（B组）及10例右室心肌梗死患者（C组）行RT-3DE检查。应用TomTec软件定量分析右室RT-3DE图像，获得右室流人道、体部、流出道局部与整体的舒张末期容积（EDV）、收缩末期容积（ESV）、每搏量（SV）、射血分数（EF）等参数，并进行组间比较，并行RT-3DE定量分析的可重复性检验。结果与A组、B组相比，C组右室体部及整体EDV、ESV均增大，右室流人道及流出道ESV增大（P〈0．05）。与B组相比，C组右室流人道EDV增大（P〈0．05）。C组右室流人道、流出道和整体的EF较A组、B组降低（P〈0．05）。C组体部EF较B组降低（P〈0．05）。A组与B组间局部与整体容积及EF比较差异无统计学意义（P〉0．05）。RT-3DE参数观察者内及观察者间变异度较低，一致性较高。结论右室心肌梗死患者右室局部与整体容积增大、收缩功能减退。RT-3DE评价右冠状动脉病变右心室局部与整体容积及功能具有较高的可重复性。

Objective To assess right ventricular （RV） regional and global volume and systolic function in patients with right coronary artery disease by real-time three-dimensional echocardiography（RT- 3DE）. Methods RT-3DE images were acquired in 20 normal controls （Group A）,30 patients with right coronary artery stenosis（Group B） and 10 patients with RV myocardial infarction（Group C）. Volumetric RT-3DE images were analyzed by use of TomTec software, which provided regional （inflow, body and outflow） and global end diastolic volume （EDV）, end systolic volume （ESV）, stroke volume（SV） and ejection fraction（EF）. RT-3DE quantitative data were analyzed to test repeatability. Results Compared with group A and group B, EDV and ESV of body and global were larger in group C; ESV of inflow and outflow were larger （ P 〈0.05）. EDV of group C was larger than group B（ P 〈0.05）. Compared with group A and group B,the EF of inflow,outflow and global in group C were lower（ P 〈0.05）. The EF of body in group C were lower than group B（ P 〈0.05）. There was no significant difference in regional and global volume and EF between group A and group B（ P 〈0.05）. The intra-observer and inter-observerls variability was low and consistency was high. Conclusions In patients with RV myocardial infarction, RV regional and global volumes were enlarged and systolic function was impaired. Evaluating right ventricular regional and global volume and function in patients with right coronary artery disease by RT-3DE has high repeatability.