实时三维超声心动图在老年非瓣膜性心房颤动患者左、右心室结构与功能评价中应用

Evaluation of structure and function of left and right ventricular in elderly patients with non-valvular atrial fibrillation by real-time three dimensional echocardiography

目的探讨实时三维超声心动图在老年非瓣膜性心房颤动患者左、右心室结构和功能评价中的应用价值。方法选取自2016年3月至2017年12月收治的105例老年非瓣膜性心房颤动患者纳入A组,将同期进行体检的100例窦性心律老年患者纳入B组。两组均行二维超声心动图、频谱多普勒、组织多普勒和实时三维超声心动图检查,比较其评估左、右心室相关指标的差异。结果二维超声检查结果显示,A组左室射血分数、右心室面积变化分数及三尖瓣环位移距离水平显著低于B组,右室舒张末期内径水平高于B组,两组间比较,差异均有统计学意义(P <0. 05)。两组频谱多普勒和组织多普勒检查结果显示,A组二尖瓣口和三尖瓣环舒张早期前向血流峰值速度E、e、E'、e'、E/E'及e/e'水平均显著高于B组,两组间比较,差异均有统计学意义(P <0. 05)。实时三维超声检查结果显示,A组左室舒张末期容积、左室收缩末期容积、右室舒张末期容积及右室收缩末期容积水平均显著高于B组,左室射血分数和右室射血分数水平均显著低于B组,两组间比较,差异均有统计学意义(P <0. 05)。结论实时三维超声心动图可简便、快速、准确地评估老年非瓣膜性心房颤动患者左、右心室的结构和功能。

Objective To investigate the application value of real-time three dimensional echocardiography in evaluating structure and function of left and right ventricular in elderly patients with non-valvular atrial fibrillation.Methods retrospective study was performed on 105 cases of elder patients with non-valvular atrial fibrillation who were admitted from March 2016 to December 2017 （Group A） ,meanwhile,another 100 cases of elderly patients with sinus rhythm（Group B）were selected.Patients of the two groups received two dimensional echocardiography,spectral Doppler echocardiography,tissue Doppler imaging（TDI）and real-time three dimensional echocardiography.The differences of related indexes of left and right ventricular between two groups were observed.Results The results of two-dimensional ultrasonography showed that left ventricular ejection fraction,right ventricular fractional area change and tricuspid annular plane systolic excursion levels of tricuspid annulus were significantly lower in Group A than in those in Group B,and right ventricular diastolic diameter level was higher than that in Group B,and the differences were statistically significant（ P 〈0.05）.The results of spectral Doppler and TDI examination of the two groups showed that in the early diastolic velocity of mitral valve and tricuspid annulus E,e,E′,e′,E/E′and e/e′ in Group A were significantly higher than those in Group B,and the differences were statistically significant（ P 〈0.05）.Real-time three-dimensional ultrasound examination showed that left ventricular end-diastolic volume,left ventricular end systolic volume,right ventricular end-diastolic volume and right ventricular end systolic volume levels in Group A were significantly higher than those of Group B,left ventricular ejection fraction and right ventricular ejection fraction levels in Group A were significantly lower than those of Group B,and the difference was statistical significant（ P 〈0.05）.Conclusion Real-time three dimensional echocardiography can simply,rapidly and accurately evaluate the structure and function of left and right ventricular in elderly patients with non-valvular atrial fibrillation.