二维斑点追踪技术评估卵圆孔未闭封堵术后左心房功能

Two-dimensional speckle tracking technique for evaluating left atrial function after patent foramen ovale closure

目的应用二维斑点追踪技术(two-dimensional speckle-tracking imaging,2D-STI)评估介入治疗对卵圆孔未闭(patent foramen ovale,PFO)患者左房功能的影响。方法选取2018年6月至2019年1月于首都医科大学附属北京天坛医院确诊、拟行介入封堵术的卵圆孔未闭患者45例为研究对象。患者术前及术后1 d、术后1个月行常规经胸超声心动图检查,存储图像,应用STI技术描记获取左房应变-时间曲线。测量储器阶段、管道阶段及泵阶段的左房整体纵向应变值,应用配对样本t检验,对术后1 d、术后1个月与术前1 d左房各阶段整体纵向应变值间的差异性进行比较。结果术后1 d左房储器阶段、管道阶段及泵阶段的整体纵向应变值均较术前明显降低(P<0.05)。术后1个月随访到的35例患者左房各阶段整体纵向应变值与术前比较差异均无统计学意义(P>0.05)。结论卵圆孔未闭封堵治疗对左房机械功能会产生一过性影响,术后1个月内需密切关注。

Objective To evaluate the effect of interventional therapy on left atrial function in patients with patent foramen ovale(PFO)using two-dimensional speckle tracking.Methods Totally 45 patients diagnosed with PFO from June 2018 to January 2019 in Beijing Tiantan Hospital,Capital Medical University,and underwent transcatheter closure of PFO were enrolled.All patients underwent transthoracic echocardiography before surgery,1 d after surgery,and 1 month after surgery,and images were stored.The left atrial strain-time curve was obtained by two-dimensional speckle tracking technique.The overall longitudinal strain values of the left atrium in the reservoir phase,the conduit phase and the contraction phase were measured.The paired sample t-test was used to compare the differences between the overall longitudinal strain values at 1 d before operation,1 d after operation and 1 month after operation.Results The overall longitudinal strain values of the left atrium on the postoperative first day were significantly lower than those before operation(P<0.05),but returned to normal after one month in 35 patients who were followed-up,with no significant difference between one month after surgery and that before surgery(P>0.05).Conclusion The closure of patent foramen ovale may has a transient effect on the left atrial mechanical function.The patient should be closely monitored within 1 month after operation.