速度向量成像对慢性肺动脉血栓栓塞症患者右室功能的评价

Assessment of right ventricular function of chronic pulmonary thromboembolism with echocardiographic velocity vector imaging

目的应用速度向量成像(VVI)技术对慢性肺动脉血栓栓塞症(PTE)患者的右室局部及整体功能进行评价。方法 69例PTE患者,于心尖四腔切面应用彩色多普勒超声根据三尖瓣最大反流速度计算肺动脉收缩压,根据肺动脉收缩压分为肺动脉高压轻、中、重度组及无肺动脉高压组;体检健康者69例为对照组。应用VVI技术评价其右室游离壁、室间隔各节段(基底段、中间段及心尖段)及右室整体纵向收缩期峰值速度、位移、应变及应变率(SR)。结果不同肺动脉收缩压组右室侧壁和室间隔各节段(基底段、中间段及心尖段)以及右室整体纵向收缩期峰值速度、位移、应变以及应变率均低于对照组(均P<0.05),其中肺动脉收缩压分级越高,上述指标越低。结论 VVI评估慢性PTE患者右室整体及局部功能异常方面具有优越性。

Objective To assess the partial and overall right ventricular function in patients of chronic pulmonary thromboembolism（PTE） using velocity vector imaging（VVI）. Methods Two-dimensional echocardiographic images from the standard apical four chambers were analyzed. Pulmonary artery systolic pressure was calculated according to tricuspid maximal regurgitant velocity in color Doppler ultrasound in 69 cases of PTE. These patients were divided into mild,moderate and severe pulmonary hypertension group according to the pulmonary artery systolic pressure, another 69 healthy cases were control group.The longitudinal systolic myocardial velocity（Vs）,displacement（D）,strain（S）,and strain rate（SR）were determined at the basal,mid and apical segments of the right lateral ventricular wall and ventricular septum by VVI. Results Compared with the control group,the Vs,D,S and SR were decreased in the right lateral ventricular wall and ventricular septum（basal,mid and apical segments）in different pulmonary hypertension groups, there was difference（ all P0.05）, and the higher the degree of pulmonary hypertension,the lower the above indicators. Conclusion VVI is useful for assessing the partial and overall function of right ventricle in patients of chronic pulmonary thromboembolism.