超声心动图对高龄CHF患者右心房结构及功能的评估价值

Evaluation value of echocardiography for right atrial structure and function in advanced aged CHF patients

目的:探讨超声心动图对高龄慢性心力衰竭(CHF)患者右心房结构及功能的评估价值。方法:选择100例CHF患者作为CHF组,同期健康体检者76例作为健康对照组。采用超声心动图检测常规超声指标,右心房结构及功能相关指标,并进行组间比较。结果:与健康对照组比较,CHF组LVEF[(65.43±7.38)%比(38.69±5.56)%]、右室侧壁收缩期位移速度[(18.25±3.62)cm/s比(9.03±2.26)cm/s]、三尖瓣环收缩期位移(TAPSE)[(19.92±4.01)mm比(14.34±3.64)mm]、右室被动排空分数(RAVpEF)[(41.79±13.24)%比(26.85±8.50)%]、舒张期早期运动峰值速度(Em)[(17.85±1.63)cm/s比(12.07±1.74)cm/s]、Em/Am[(1.45±0.22)比(0.84±0.17)均显著下降;肺动脉收缩压(PASP)[(28.73±6.24)mmHg比(53.22±4.63)mmHg]、右心房最大容积/体表面积(RAVmax/BSA)、右心房最小容积(RAVmin)/BSA、右心房收缩期前容积(RAVpre)/BSA、总排空容积(RAVt)[(31.75±10.17)ml比(37.62±11.88)ml]、被动排空容积、主动排空分数(RAVaEF)[(26.72±6.17)%比(31.24±7.09)%]、E/Em[(3.35±0.75)比(5.12±0.89)]和Tei指数[(0.35±0.08)比(0.72±0.16)]均显著升高,P均=0.001。结论:LVEF,右室侧壁收缩期位移速度,TAPSE下降,肺动脉收缩压上升,说明左室收缩功能下降,其扩展导致右室收缩功能下降,从而导致右房容积扩大,而右房排空分数、E/Em、Tei指数显著升高,提示这组患者右房收缩功能尚处于代偿期,应加强治疗改善患者预后。

Objective:To explore evaluation value of echocardiography(ECG)for right atrial structure and function in advanced aged patients with chronic heart failure(CHF).Methods:A total of 100 CHF patients(CHF group)and 76 healthy subjects(healthy control group)were enrolled.ECG was used to detect routine ultrasound indexes,right atrial structural and functional indexes,then above indexes were compared between two groups.Results:Compared with healthy control group,there were significant reductions in LVEF[(65.43±7.38)%vs.(38.69±5.56)%],right ventricular sidewall systolic displacement speed[(18.25±3.62)cm/s vs.(9.03±2.26)cm/s],tricuspid annular plane systolic excursion(TAPSE)[(19.92±4.01)mm vs.(14.34±3.64)mm],passive emptying fraction of right atrium(RAVpEF)[(41.79±13.24)%vs.(26.85±8.50)%],early diastolic peak velocity(Em)[(17.85±1.63)cm/s vs.(12.07±1.74)cm/s],Em/late diastolic peak velocity(Am)[(1.45±0.22)vs.(0.84±0.17)];significant rise in pulmonary arterial systolic pressure(PASP)[(28.73±6.24)mmHg vs.(53.22±4.63)mmHg],maximum right atrial volume/body surface area(RAVmax/BSA),minimum right atrial volume(RAVmin)/BSA,right atrial presystolic volume(RAVpre)/BSA,total stroke volume of right atrium(RAVt)[(31.75±10.17)ml vs.(37.62±11.88)ml],passive emptying volume of right atrium(RAVp),active emptying fraction of right atrium(RAVaEF)[(26.72±6.17)%vs.(31.24±7.09)%],E/Em[(3.35±0.75)vs.(5.12±0.89)]and Tei index[(0.35±0.08)vs.(0.72±0.16)]in CHF group,P=0.001 all.Conclusion:LVEF,right ventricular sidewall systolic displacement speed and TAPSE decline,PASP rises,indicating that left ventricular systolic function declines,its extension leads to right ventricular systolic function decline;so leads to right atrial volume expansion,emptying fraction of right atrium,E/Em,Tei index significantly rise,indicating that right atrial systolic function still are compensated stage in patients of this group,so should enhance treatment for improve prognosis.