fetal HQ软件定量评价不同原因所致胎儿中重度三尖瓣反流时双心室收缩功能

Quantitative Evaluation of Cardiac Systolic Function of Fetal Moderate-to-Severe Tricuspid Regurgitation Caused by Different Reasons by Using Fetal HQ

目的利用fetal HQ技术评估不同原因导致胎儿三尖瓣中重度反流时左、右心室收缩功能,比较其与正常胎儿的差异。资料与方法回顾性分析右心室容量过重18例胎儿和右心室压力负荷过重31例胎儿的超声心动图资料,分别选取与右心室容量过重组孕周相符的18例胎儿为对照组1,与右心室压力负荷过重组孕周相符的31例胎儿作为对照组2。应用fetal HQ软件测量胎儿四腔心切面,并自动计算左心室射血分数(LVEF)、左、右心室面积变化率(LV/RV-FAC)和左、右心室整体应变(LV/RVGS),比较右心室容量过重和压力负荷过重时对胎儿左、右心室收缩功能的影响。结果与对照组1比较,右心室容量过重组LV-GS、LV-FAC及LVEF较低(P均<0.05);而RV-GS和RV-FAC比较,差异无统计学意义(P>0.05)。与对照组2比较,右心室压力负荷过重组RV-GS及RV-FAC较低(P均<0.001),而LV-GS、LV-FAC及LVEF差异无统计学意义(P>0.05)。结论不同原因导致胎儿中重度三尖瓣反流时,对左、右心室收缩功能影响不同,右心室容量过重时,左心室收缩功能减低;右心室压力负荷过重时,右心室收缩功能减低。

Purpose To evaluate the left and right ventricle function of fetuses with moderate-to-severe tricuspid regurgitation caused by different reasons using fetal heart quantification(fetal HQ)technology,and to compare the difference between them and normal fetuses.Materials and Methods The echocardiography data of 18 cases caused by increased right ventricle volume load and 31 cases caused by increased right ventricle pressure load were retrospectively analyzed,18 fetuses in accordance with the increased right ventricular volume were selected as the control group 1,and 31 fetuses in accordance with the increased right ventricular pressure load were selected as the control group 2.fetal HQ software was used to measure and automatically calculate left ventricular ejection fraction(LVEF),left/right ventricular fraction area change(LV/RV-FAC)and left/right ventricular global strain(LV/RV-GS)on fetal four chamber views.The left and right ventricle systolic function caused by increased right ventricle volume load and pressure load was compared.Results Compared with the control group 1,the LV-GS,LV-FAC and LVEF were lower in the increased right ventricle volume load group(P<0.05),while the RV-GS and RV-FAC showed no statistical difference(P>0.05);compared with the control group,only RV-GS and RV-FAC were lower in the right ventricle pressure load group(P<0.001),the LV-GS,LV-FAC and LVEF showed no significant difference(P>0.05).Conclusion The effects on left and right ventricular systolic function are different on fetuses with moderate-to-severe tricuspid regurgitation caused by different reasons.When the right ventricle volume load increases,the left ventricular systolic function decreases,whereas when the right ventricle pressure load increases,the right ventricular systolic function decreases.