超声心动图自动心肌运动定量与三维定量分析评估左室收缩功能应用价值比较

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(房颤)患者左右心室结构和功能评价中的价值。方法选取青海省心脑血管病专科医院自2016年3月至2017年12月收治的老年非瓣膜性房颤患者105例为研究对象,设为A组,另选取同期100例窦性心律老年患者作为B组。两组均采用二维超声心动图、频谱多普勒、组织多普勒(TDI)和实时三维超声心动图检查,比较两组左右心室相关指标的差异。结果二维超声、频谱多普勒和TDI结果中,A组左室射血分数、右心室面积变化分数和三尖瓣环位移显著低于B组,两组比较,差异有统计学意义(P <0. 05); A组右室舒张末期内径、三尖瓣环舒张早期前向血流峰值速度/血流峰值速度、二尖瓣口舒张早期前向血流峰值速度/血流峰值速度显著高于B组,两组比较,差异有统计学意义(P <0. 05)。实时三维超声结果中,A组左室舒张末期容积、左室收缩末期容积、右室舒张末期容积和右室收缩末期容积显著高于B组,两组比较,差异有统计学意义(P <0. 05); A组LVEF和右室射血分数显著低于B组,两组比较,差异有统计学意义(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房颤患者左右心室结构和功能。

Objective To investigate the clinical value of automated cardiac motion quantification (aCMQ) and three-dimensional quantitative analysis(3DQA) in evaluating left ventricular systolic function. Methods A retrospective study was performed on 60 cases of patients with 3DQA who were perfor^ned 3DQA from December 2017 to May 2018. According to the left ventricular ejection frac-tion(LVEF) score，all patients were divided into the abnormal group(几= 30) and the normal group( n =30). Two groups of patients were compared with 3DQA and aCMQ on left ventricular end-diastolic volume ( LVEDV)，left ventricular end systolic volume (LVESV)，the difference of LVEF and aCMQ check on four cavity heart left ventricular long axis strain values(LVAP4LS)，two cavity heart long axis strain values(LVAP2LS)，three cavity heart long axis strain values(LVAP3LS) and left ventricular long axis of the whole strain values(LVGLS) difference. The correlation and repeatability of the two methods were evaluated. Results Both 3DQA and aCMQ examination indicated that LVEDV and LVESV in the LVEF abnormal group were significantly higher than that in the LVEF nor^mal group，while LVEF was significantly lower than that in the LVEF nor^mal group( P <0. 05). There was no statistically significant difference between the two methods( P >0. 05). The results of aCMQ showed that the absolute values of LVAP4LS，LVAP2LS， LVAP3LS and LVGLS in the LVEF abnormal group were significantly lower than those in the LVEF normal group(P <0. 05). There was a significant positive correlation between aCMQ and LVEDV，LVESV and LVEF in the two groups measured by 3DQA( P < 0. 05). There was a significant negative correlation between LVGLS measured by aCMQ and LVEF measured by 3DQA( P <0. 05). The variation coefficient of aCMQ and 3DQA measured values of operators themselves was less than that between operators， and the variation coefficient of LVEF measured by aCMQ was less than that between operators themselves and 3DQA. Bland-altman analysis showed that the consistency of aCMQ and 3DQA value operators themselves was better than that of other operators，while the consistency of aCMQ LVEF value measured by aCMQ was better than that of 3DQA. Conclusion The indicators of left ventricular systolic function measured by aCMQ are significantly correlated with 3DQA，and have good repeatability.