实时三维超声心动图评价房颤患者右心功能的应用研究

Application of real-time three-dimensional echocardiography in evaluating right cardiac function in patients with atrial fibrillation

目的探讨经胸实时三维超声心动图(RT-3DE)评价房颤患者右心功能的应用价值。方法对60例房颤患者(AF组)和50例门诊体检健康人群(对照组)均进行RT-3DE检查获得右心容积和功能相关参数。观察不同AF类型、AF术后复发组或窦性心律组右心容积和功能相关参数差异,分析其与AF术后复发的相关性。结果AF组患者右心室最小容积(RVVmin)、右心室最大容积(RVVmax)高于对照组(P<0.05),收缩期至舒张末期三尖瓣环位移(TAPSE)、右心室射血分数(RVEF)、下腔静脉塌陷率(ΔIVC)低于对照组(P<0.05),持续性房颤(SAF)组右心室做功指数(MPI)高于阵发性房颤(PAF)组(P<0.05),TAPSE、ΔIVC低于PAF组(P<0.05)。AF复发组术后TAPSE、RVEF、ΔIVC低于窦性节律组(P<0.05),MPI高于窦性节律组(P<0.05)。结论经胸RT-3DE可定量评价AF患者右心结构和功能,对于病情评估、疗效判断均有一定价值。

Objective To investigate the value of real-time three-dimensional echocardiography(RT-3DE)in evaluating right ventricular function in patients with atrial fibrillation.Methods RT-3DE was performed in 60 patients with atrial fibrillation(AF group)and 50 healthy outpatients(control group)to obtain right ventricular volume and function parameters.We observed the difference of right ventricular volume and function related parameters among different AF types,AF recurrence group or sinus rhythm group,and analyzed the correlation between right ventricular volume and function related parameters and AF recurrence.Results RVVmax and RVVmin in AF group were higher than those in control group(P<0.05),TAPSE,RVEF andΔIVC were lower than those in control group(P<0.05).MPI of steadines atrial fibrillation(SAF)group was higher than that of persistent atrial fibrillation(PAF)group(P<0.05),TAPSE andΔIVC were lower than that of PAF group(P<0.05).TAPSE,RVEF andΔIVC in AF recurrence group were lower than those in sinus rhythm group(P<0.05),and MPI was higher than that in sinus rhythm group(P<0.05).ROC analysis showed that the area under curve(AUC)of TAPSE and RVEF predicting AF recurrence was were 0.693 and 0.714,respectively.Conclusion Transthoracic RT-3DE can quantitatively evaluate the structure and function of right heart in AF patients.It has certain value in evaluating the condition and judging the curative effect.