三维经胸超声心动图评价中重度二尖瓣反流患儿瓣环动态变化的效果分析

Effect of three-dimensional transthoracic echocardiography in evaluation of the dynamic changes of valve annulus in patients with moderate to severe mitral regurgitation

目的:观察应用三维经胸超声心动图评价中重度二尖瓣反流患儿瓣环动态变化的效果。方法:回顾性分析、比较84例中重度二尖瓣反流患儿(反流组患儿)和75例二尖瓣功能正常儿童(正常组儿童)的三维经胸超声心动图图像参数值及在整个心动周期内二尖瓣瓣环的形态变化情况。结果:整个心动周期内,反流组患儿和正常组儿童的二尖瓣瓣环均呈马鞍形。其中,在收缩早期,正常组儿童瓣环的面积、前-后直径、前外-后内侧直径、非平面角均较舒张末期减小,高度较舒张末期增大(均P<0.05),而反流组患儿的这些参数值均无显著变化(均P>0.05)。结论:反流组患儿和正常组儿童的二尖瓣瓣环均呈马鞍形。在心动周期收缩早期,正常组儿童的瓣环形态明显加深,在心脏收缩前发生收缩,而反流组患儿的瓣环形态明显增大,心脏收缩前不发生收缩,但在收缩中、末期趋于扁平化,收缩动能减弱。

Objective:To explore the effect of three-dimensional transthoracic echocardiography(3D-TTE)in evaluation of the dynamic changes of valve ring in patients with moderate to severe mitral regurgitation(MR).Methods:The 3D-TTE image parameters and the morphological changes of mitral annulus in 84 children with moderate to severe MR(regurgitation group)and 75 children with normal mitral valve function(normal group)were retrospectively analyzed and compared.Results:During the whole cardiac cycle,the mitral rings in both groups were saddle shaped.In the early systolic stage,the area,anterior-to-posterior diameter,anterior-to-medial diameter and non-plane angle of the flap ring in the normal group were decreased and the height was increased compared with the end diastolic stage(all P<0.05),while there were no significant changes in these parameters in the regurgitation group(all P>0.05).Conclusion:The mitral annulus is saddle-shaped in both groups.The saddle-shape in normal group is significantly deepened in the early stage of cardiac cycle contraction,and contraction occurred before cardiac contraction.The annulus in regurgitation group is significantly increased,and there is no contraction before cardiac contraction.However,the annulus tends flat at the middle to end of the contraction and the kinetic energy of contraction is weakened.