RT-3DE在评价儿童动脉导管未闭封堵术前后左心室功能的应用

Evaluation of Left Ventricular Function in Children with Patent Ductus Arteriosus before and after Transcatheter Closure Using Real-time Three-dimensional Echocardiography

目的应用实时三维超声心动图(real-time three-dimensional echocardiography,RT-3DE)评价儿童动脉导管未闭(patent ductus arteriosus,PDA)导管封堵术前后左心室功能。方法选取PDA患儿15例(手术组)及正常儿童12例(对照组)。应用RT-3DE测算对照组、导管封堵组术前和术后1月左心室心肌质量指数(left ventricular mass index,LVMI)、左心室舒张末期容积指数(left ventricular end-diastolic volume index,LVEDVI)、左心室射血分数(left ventricle ejection fraction,LVEF)。结果与对照组比较,导管封堵组术前LVMI及LVEDVI绝对值明显增高(P<0.05),LVEF无明显变化(P>0.05);与导管封堵组术前比较,术后LVMI及LVEDVI明显降低(P<0.05)。结论应用实时三维超声心动图可发现PDA患儿在LVEF正常时就已经出现左心室LVMI及LVEDVI的显著升高;LVMI及LVEDVI可作为评价PDA患儿导管封堵后左心室功能早期改善的一项重要指标。

Objective To evaluate the function of the left ventricular（ LV） using real-time three-dimensional echocardiography（ RT-3DE） in children with patent ductus arteriosus（ PDA） before and after Transcatheter Closure. Methods 15 children with PDA undergoing Transcatheter Closure.（ transcatheter closure group） and12 healthy subjects（ control group） were enrolled. left ventricular mass index（ LVMI）,left ventricular end-diastolic volume index（ LVEDVI） and left ventricular ejection fraction（ LVEF） were measured by RT-3DE in the transcatheter closure group and the control group before transcatheter closure and 1 month after Transcatheter closure.Results Compared with the control group,the absolute values of LVMI and LVEDVIincreased significantly before dialysis（ P 〈 0. 05）,and we did not observed any significant difference in LVEF（ P 〉 0. 05）. In the transcatheter closure group,the absolute value of LVMI and LVEDVIdecreased significantly as compared with those before transcatheter closure（ P 〈 0. 05）. Conclusions The application of RT-3DE can facilitate the early detection of increased LVMI and LVEDVI of theleft ventricle in children with patent ductus arteriosus when LVEF was normal.LVMI and LVEDVI can be used as an important parameter for left ventricular function improvement in children withpatent ductus arteriosus undergoing transcatheter closure.