斑点追踪应变成像评价正常人左心房与右心房功能的差异性

Speckle tracking echocardiography for assessment of left and right atrial dissimilarities in healthy subjects

目的应用二维斑点追踪显像(2D speckle tracking echocardiography,2DSTE)技术探讨正常人左心房(LA)与右心房(RA)功能的差异性。方法正常人148名,获取心尖四腔观和二腔观图像,应用Tom Tec软件脱机分析心房应变及应变率参数:反映心房储存功能的收缩期整体纵向峰值应变εs、反映心房管道功能的舒张早期心房整体纵向峰值应变εe、反映心房泵功能的舒张晚期心房整体纵向峰值应变εa,以及对应时相的应变率参数SRs、SRe、SRa。结果 LA最大容积(43±11)ml、储存功能参数[充盈总容积(30±9)ml,扩张指数(193±92)%,舒张期排空指数(63±11)%]和通道功能参数[被动排空指数(30±10)%]均显著高于RA上述指标[分别为(38±10)ml、(21±7)ml、(138±79)%、(54±12)%和(25±13)%],均P<0.01。而与之相反的是,应变分析结果显示RAεs(59±8)%,SRs(2.5±0.7)/s,εe(32±10)%和εa(-29±11)%均显著高于LAεs(43±6)%,SRs(2.3±0.7)/s,εe(23±5)%和εa(-20±3)%,均P<0.01。结论应用2DSTE技术测得正常人LA和RA的功能存在差异性。

AIM To explore the dissimilarities of left and right atrial （LA and RA） functions in normal subjects using two-dimensional speckle tracking echocardiography （2DSTE）. METHODS 2D images were acquired from the apical four- and two-chamber view in 148 normal subjects. Stain and strain rate were obtained, respectively, in ventricular systole, early diastole and late diastole using TomTec software. Strain parameters （ss, ae, aa） corresponded, respectively, to atrial reservoir, conduit and booster pump JPfunctions and the strain rate parameters included SRs, SRe and SRa. RESULTS Vmax （43 ±11 ） ml vs. （38 ±10） ml, reservoir function parameters [filling volume = （30±9） ml vs. （21 ±7） ml; expansion index = （193 ±92）% vs. （138 ±79）% ; diastolic emptying index = （63 ±11）% vs. （54 ±12）% ] and con- duit function parameters [passive emptying index = （30 ± 10）% vs. （25 ± 13）% ] of LA were significantly higher than those of RA. Contrarily, deformation indicators of RA strain and strain rate parameters were significantly higher than those of LA [as （59 ±8）% vs. （43 ±6）% ; SRs （2. 5 ±0. 7）/s vs. （2. 3 ±0. 7）/s; ae （32±10）% vs. （23±5）%; ea （ -29±11）% vs. （ -20±3）%]. CONCLUSION Dissimilari- ties of left atrium and right atrium exist in normal subjects. 2DSTE can be used to objectively evaluate leftand right atrial functions, which provides a research foundation for studies on atrium functions in different diseases.