二维斑点追踪成像技术评价肥厚型心肌病右心房功能

Assessment of right atrial function in hypertrophic cardiomyopathy by two-dimensional speckle tracking imaging

目的:应用二维斑点追踪成像技术(2D-STI)评价肥厚型心肌病(HCM)的右心房功能。方法:选取70例HCM患者和40例年龄、性别相匹配的正常对照组纳入本研究,分析比较两组常规超声心动图参数和二维应变参数。结果:(1)与对照组相比较,HCM患者的室间隔厚度、左心室后壁厚度、右心房舒张末期容积均增大,而三尖瓣环收缩期位移、三尖瓣环侧壁收缩峰值速度及右心房排空分数均减低,差异均具有统计学意义(P<0.05)。(2)HCM患者的右心室收缩期整体纵向峰值应变、右心房收缩期整体纵向峰值应变、右心房各节段收缩期纵向峰值应变(右心房侧壁、右心房顶部和右心房间隔)、右心房间隔收缩期纵向峰值应变率的绝对值均低于对照组,差异均具有统计学意义(P<0.05)。结论:2D-STI可准确评价HCM患者右心房功能受损情况,为临床评估HCM患者的右心房功能提供了新的选择。

Objective: To assess right atrial(RA) function of patients with hypertrophic cardiomyopathy(HCM) by two-dimensional speckle tracking imaging(2D-STI). Methods: Seventy HCM patients and forty control subjects were recruited,conventional echocardiographic parameters and strain parameters were analyzed and compared between the two groups. Results:(1)Compared with the control group, the interventricular septal thickness, left ventricular posterior wall thickness and right atrium end diastolic volume of HCM group were increased, while the tricuspid annular plane systolic excursion, peak systolic velocity of tricuspid annulus and right atrial emptying fraction of the HCM group were reduced(all P<0.05).(2)Absolute value of right ventricular systolic global longitudinal strain, right atrial peak systolic global longitudinal strain, right atrial peak systolic segment longitudinal strain(lateral wall, roof and septum of the right atrium) and peak systolic longitudinal strain rate of septum of right atrium in the HCM group were significantly lower than those in the control group(all P<0.05). Conclusion:2D-STI can accurately evaluate the impairment of right atrial function in HCM patients, providing a new option for clinical evaluation of right atrial function in HCM patients.