实时三维超声心动图评估完全性肺静脉异位引流患儿心室容积及功能

Real-time three-dimensional echocardiography for evaluation on biventricular volume and function for infants with total anomalous pulmonary venous drainage

目的探讨实时三维超声心动图(RT-3DE)评估完全性肺静脉异位引流(TAPVD)患儿心室容积及功能的可行性。方法对16例仅合并房间隔缺损或卵圆孔未闭的单纯性TAPVD患儿(TAPVD组)及19名健康婴幼儿(对照组)采用二维超声心动图测量左心室前后径(LVD)、右心室横径(RVD)、左心室射血分数(M型,LVEF-M)、三尖瓣环收缩期位移(TAPSE)及三尖瓣环收缩期峰值运动速度(TAV),以RT-3DE测量左心室/右心室射血分数(LVEF-3DE、RVEF-3DE)及体表面积(BSA)标化左心室/右心室舒张末期容积(LVEDV/BSA、RVEDV/BSA),比较组间差异。结果TAPVD组RVD、LVEF-M、RVEDV/BSA高于对照组,LVD、TAPSE、TAV、RVEF-3DE、LVEDV/BSA低于对照组(P均<0.05),2组LVEF-3DE差异无统计学意义(P>0.05)。结论RT-3DE可用于评估TAPVD患儿心室容积及功能。

Objective To explore the feasibility of real-time three-dimensional echocardiography(RT-3DE)for evaluation on biventricular volume and function for children with total anomalous pulmonary venous drainage(TAPVD).Methods Totally 16 children with simple TAPVD combined with atrial septal defect or patent foramen ovale(TAPVD group)and 19 normal infants(as control group)were recruited.The following indexes,including left ventricular anteroposterior dimension(LVD),right ventricular transverse dimension(RVD),left ventricular ejection fraction by M-mode(LVEF-M),tricuspid annular plane systolic excursion(TAPSE)and peak velocity of tricuspid annulus(TAV)were measured with two-dimensional echocardiography.Then left/right ventricular ejection fraction(LVEF-3DE,RVEF-3DE)obtained by RT-3DE and left/right ventricular end diastolic volume corrected by body surface area(BSA)(LVEDV/BSA,RVEDV/BSA)were measured.The above parameters were compared between 2 groups.Results RVD,LVEF-M and RVEDV/BSA in TAPVD group were significantly higher than those in control group,whereas LVD,TAPSE,TAV,RVEF-3DE and LVEDV/BSA were lower than in control group(all P<0.05).No significant difference of LVEF-3DE was found between 2 groups(P>0.05).Conclusion RT-3DE can be used to evaluate biventricular volume and function in children with TAPVD.