The optimal plane for measurement of the right ventricular (RV) volumes by real-time three-dimensional echocardiography (RT3DE) was determined and the feasibility and accuracy of RT3DE in studying RV systolic function...The optimal plane for measurement of the right ventricular (RV) volumes by real-time three-dimensional echocardiography (RT3DE) was determined and the feasibility and accuracy of RT3DE in studying RV systolic function was assessed. RV “Full volume” images were acquired by RT3DE in 22 healthy subjects. RV end-diastolic volumes (RVEDV) and end-systolic volumes (RVESV) were outlined using apical biplane, 4-plane, 8-plane, 16-plane offline separately. RVSV and RVEF were calculated. Meanwhile tricuspid annual systolic excursion (TASE) was measured by M-mode echo. LVSV was outlined by 2-D echo according to the biplane Simpson's rule. The results showed: (1) There was a good correlation between RVSV measured from series planes and LVSV from 2-D echo (r=0.73; r=0.69; r=0.63; r=0.66, P<0.25—0.0025); (2) There were significant differences between RVEDV in biplane and those in 4-, 8-, 16-plane (P<0.001). There was also difference between RV volume in 4-plane and that in 8-plane (P<0.05), but there was no significant difference between RV volume in 8-plane and that in 16-plane (P>0.05); (3) Inter-observers and intro-observers variability analysis showed that there were close agreements and relations for RV volumes (r=0.986, P<0.001; r=0.93, P<0.001); (4) There was a significantly positive correlation of TASE to RVSV and RVEF from RT3DE (r=0.83; r=0.90). So RV volume measures with RT3DE are rapid, accurate and reproducible. In view of RV's complex shape, apical 8-plane method is better in clinical use. It may allow early detection of RV systolic function.展开更多
目的探讨多模态超声心动图对肺动脉高压患者右心功能的诊断效能。方法选取2022年1月至2023年8月于金华市中心医院就诊的80例肺动脉高压患者纳入观察组,根据患者的肺动脉收缩压将其分为轻度组[40~50mmHg(1mmHg=0.133kPa),36例]、中度组(5...目的探讨多模态超声心动图对肺动脉高压患者右心功能的诊断效能。方法选取2022年1月至2023年8月于金华市中心医院就诊的80例肺动脉高压患者纳入观察组,根据患者的肺动脉收缩压将其分为轻度组[40~50mmHg(1mmHg=0.133kPa),36例]、中度组(51~70mmHg,20例)和重度组(>70mmHg,24例);选取同期健康体检者80名纳入对照组,所有受试者均进行多模态超声心动图检测,对比其超声检查相关数据,评估多模态超声心动图对肺动脉高压患者右室收缩功能的诊断效能。结果观察组患者的右室舒张末期容积(right ventricular end diastolic volume,RVEDV)、右室收缩末期容积(right ventricular end systolic volume,RVESV)、右室整体无效做功(right ventricular global waste work,RVGWW)均显著高于对照组,右室每搏输出量(right ventricular stroke volume,RVSV)、右室射血分数(right ventrical ejection fraction,RVEF)、三尖瓣环收缩期位移(tricuspid annular plane systolic excusion,TAPSE)、整体纵向应变(global longitudinal strain,GLS)、右室整体做功效率(right ventricular global work efficiency,RVGWE)、右室整体做功指数(right ventricular global work index,RVGWI)、右室整体有效做功(right ventricular global constructive work,RVGCW)均显著低于对照组(P<0.05)。重度组患者的RVEDV、RVESV及RVGWW均显著高于中度组、轻度组,RVSV、RVEF、RVGWE、RVGWI、RVGCW均显著低于中度组、轻度组(P<0.05)。TAPSE、GLS、RVSV、RVEF、RVGWI五项联合诊断肺动脉高压患者右心功能的曲线下面积为0.911,敏感度为92.23%,特异性为96.45%。结论多模态超声心动图能有效评价肺动脉高压患者的右室收缩功能,值得临床推广应用。展开更多
目的应用实时三维超声心动图(RT-3DE)评价WHO功能Ⅰ级肺动脉高压(WHO FCⅠPH)患者右心房功能。方法选取2014年2月~2016年6月在南方医科大学附属深圳宝安医院经临床诊断为WHO FCⅠ级PH、且经胸超声心动图三尖瓣反流法估测肺动脉收缩压(PA...目的应用实时三维超声心动图(RT-3DE)评价WHO功能Ⅰ级肺动脉高压(WHO FCⅠPH)患者右心房功能。方法选取2014年2月~2016年6月在南方医科大学附属深圳宝安医院经临床诊断为WHO FCⅠ级PH、且经胸超声心动图三尖瓣反流法估测肺动脉收缩压(PASP)≥40 mm Hg的患者41例为PH组,以及一般资料相匹配并经体检证实的健康者32例为正常对照组,采集所有研究对象右心房全容积图像,导入QLAB 9.0(10.5)软件分析,得到心动周期不同时相右心房容积,并以体表面积校正,得到右心房最大容积指数(RAVI_(max))、最小容积指数(RAVI_(min))、收缩前容积指数(RAVI_(pre))。并通过计算得到右心房总排空容积指数(RAVI_t),代表储存器功能;右心房被动排空容积指数(RAVI_p),右心房被动排空分数(RAEFp),代表管道功能;右心房主动排空容积指数(RAVI_a),右心房主动排空分数(RAEFa),代表助力泵功能。组织多普勒测量三尖瓣环右心室游离壁舒张期运动速度(e/a);M型超声测量三尖瓣环右心室游离壁收缩期位移(TAPSE),Simpson法测量右心室射血分数(RVEF)。比较两组间各参数的差异。结果与正常对照组比较,PH组TAPSE、RVEF差异无统计学意义(P>0.05),RAVI_(max)、RAVI_(pre)、RAVI_(min)、RAVI_t、RAVI_a显著增加(P<0.05或P<0.01),而RAVI_p、RAEFp、e/a显著减低(P<0.05)。结论 WHO FCⅠPH患者右心房管道功能减低,助力泵功能和储存器功能增强,RT-3DE提供了无创性评价的新方法。展开更多
文摘The optimal plane for measurement of the right ventricular (RV) volumes by real-time three-dimensional echocardiography (RT3DE) was determined and the feasibility and accuracy of RT3DE in studying RV systolic function was assessed. RV “Full volume” images were acquired by RT3DE in 22 healthy subjects. RV end-diastolic volumes (RVEDV) and end-systolic volumes (RVESV) were outlined using apical biplane, 4-plane, 8-plane, 16-plane offline separately. RVSV and RVEF were calculated. Meanwhile tricuspid annual systolic excursion (TASE) was measured by M-mode echo. LVSV was outlined by 2-D echo according to the biplane Simpson's rule. The results showed: (1) There was a good correlation between RVSV measured from series planes and LVSV from 2-D echo (r=0.73; r=0.69; r=0.63; r=0.66, P<0.25—0.0025); (2) There were significant differences between RVEDV in biplane and those in 4-, 8-, 16-plane (P<0.001). There was also difference between RV volume in 4-plane and that in 8-plane (P<0.05), but there was no significant difference between RV volume in 8-plane and that in 16-plane (P>0.05); (3) Inter-observers and intro-observers variability analysis showed that there were close agreements and relations for RV volumes (r=0.986, P<0.001; r=0.93, P<0.001); (4) There was a significantly positive correlation of TASE to RVSV and RVEF from RT3DE (r=0.83; r=0.90). So RV volume measures with RT3DE are rapid, accurate and reproducible. In view of RV's complex shape, apical 8-plane method is better in clinical use. It may allow early detection of RV systolic function.
文摘目的探讨多模态超声心动图对肺动脉高压患者右心功能的诊断效能。方法选取2022年1月至2023年8月于金华市中心医院就诊的80例肺动脉高压患者纳入观察组,根据患者的肺动脉收缩压将其分为轻度组[40~50mmHg(1mmHg=0.133kPa),36例]、中度组(51~70mmHg,20例)和重度组(>70mmHg,24例);选取同期健康体检者80名纳入对照组,所有受试者均进行多模态超声心动图检测,对比其超声检查相关数据,评估多模态超声心动图对肺动脉高压患者右室收缩功能的诊断效能。结果观察组患者的右室舒张末期容积(right ventricular end diastolic volume,RVEDV)、右室收缩末期容积(right ventricular end systolic volume,RVESV)、右室整体无效做功(right ventricular global waste work,RVGWW)均显著高于对照组,右室每搏输出量(right ventricular stroke volume,RVSV)、右室射血分数(right ventrical ejection fraction,RVEF)、三尖瓣环收缩期位移(tricuspid annular plane systolic excusion,TAPSE)、整体纵向应变(global longitudinal strain,GLS)、右室整体做功效率(right ventricular global work efficiency,RVGWE)、右室整体做功指数(right ventricular global work index,RVGWI)、右室整体有效做功(right ventricular global constructive work,RVGCW)均显著低于对照组(P<0.05)。重度组患者的RVEDV、RVESV及RVGWW均显著高于中度组、轻度组,RVSV、RVEF、RVGWE、RVGWI、RVGCW均显著低于中度组、轻度组(P<0.05)。TAPSE、GLS、RVSV、RVEF、RVGWI五项联合诊断肺动脉高压患者右心功能的曲线下面积为0.911,敏感度为92.23%,特异性为96.45%。结论多模态超声心动图能有效评价肺动脉高压患者的右室收缩功能,值得临床推广应用。
文摘目的应用实时三维超声心动图(RT-3DE)评价WHO功能Ⅰ级肺动脉高压(WHO FCⅠPH)患者右心房功能。方法选取2014年2月~2016年6月在南方医科大学附属深圳宝安医院经临床诊断为WHO FCⅠ级PH、且经胸超声心动图三尖瓣反流法估测肺动脉收缩压(PASP)≥40 mm Hg的患者41例为PH组,以及一般资料相匹配并经体检证实的健康者32例为正常对照组,采集所有研究对象右心房全容积图像,导入QLAB 9.0(10.5)软件分析,得到心动周期不同时相右心房容积,并以体表面积校正,得到右心房最大容积指数(RAVI_(max))、最小容积指数(RAVI_(min))、收缩前容积指数(RAVI_(pre))。并通过计算得到右心房总排空容积指数(RAVI_t),代表储存器功能;右心房被动排空容积指数(RAVI_p),右心房被动排空分数(RAEFp),代表管道功能;右心房主动排空容积指数(RAVI_a),右心房主动排空分数(RAEFa),代表助力泵功能。组织多普勒测量三尖瓣环右心室游离壁舒张期运动速度(e/a);M型超声测量三尖瓣环右心室游离壁收缩期位移(TAPSE),Simpson法测量右心室射血分数(RVEF)。比较两组间各参数的差异。结果与正常对照组比较,PH组TAPSE、RVEF差异无统计学意义(P>0.05),RAVI_(max)、RAVI_(pre)、RAVI_(min)、RAVI_t、RAVI_a显著增加(P<0.05或P<0.01),而RAVI_p、RAEFp、e/a显著减低(P<0.05)。结论 WHO FCⅠPH患者右心房管道功能减低,助力泵功能和储存器功能增强,RT-3DE提供了无创性评价的新方法。
