斑点追踪显像评价房间隔缺损封堵前后右心室功能  

Assessment of Right Ventricular Function in Patients with Atrial Septal Defect before and after Percutaneous Closure Using Speckle Tracking Imaging

作　　者：杨性安[1] 王刚[1] 丁晓明[1] 朱佳[1] 

机构地区：[1]浙江省台州医院超声科,浙江省临海市317000

出　　处：《中国全科医学》2014年第3期347-349,共3页Chinese General Practice

摘　　要：目的利用斑点追踪显像(STI)评价房间隔缺损(ASD)封堵前后右心室功能的变化。方法选择2008年1月—2012年11月浙江省台州医院心内科封堵治疗成功、超声二维图像质量良好的ASD患者57例为ASD组,另选择同时期体检健康者57例为对照组,利用STI对ASD患者在封堵前、封堵3个月后和对照组受检者分别测量心尖四腔心切面右心室游离壁和室间隔各节段(基底段、中间段和心尖段)的收缩期峰值纵向应变(PSLS)。结果 ASD组封堵前与ASD组封堵后和对照组比较,右室舒张末期内径(RVEDD)、右室面积变化分数(RVFAC)、右房室瓣环收缩期位移(TAPSE)增大,左室舒张末期内径(LVEDD)减小(P<0.05);ASD组封堵后与对照组比较,RVEDD增大,LVEDD减小(P<0.05)。ASD组封堵前较ASD组封堵后和对照组右心室游离壁基底段、游离壁中间段、游离壁心尖段、室间隔心尖段及右心室整体PSLS增大(P<0.05)。以右心室游离壁心尖段PSLS预测封堵后ASD预后的最佳截断值为-22.3%,敏感度为82.9%,特异度为75.0%。结论 STI可以定量评价ASD封堵前后右心室功能变化,右心室PSLS可以预测ASD治疗后预后情况。Objective To evaluate right ventricular function in patients with atrial septal defect （ASD） before and af- ter percutaneous closure using speckle tracing imaging （STI） . Methods From January 2008 to November 2012, a total of 57 patients with ASD received successful transcatheter therapy in Taizhou hospital of Zhejiang province, all ultrasound two - dimensional images of ASD patients had good quality, the above 57 cases were selected as ASD group, 57 healthy controls were selected as control group in the same period. Peak systolic longitudinal strain （PSLS） were measured in the basal, mid and apical seg- ments of free and septal wails in apical 4 - chamber view among ASD group before and 3 months after percutaneous closure and control group. Results Compared with control group and ASD patients who had received percutaneous closure, right ventricular end- diastolic diameter （RVEDD）, right ventricular fractional area change （RVFAC） and tricuspid annulus systolic displacement （TAPSE） increased in ASD patients before percutaneous closure, while left ventricular end - diastolic diameter （LVEDD） decreased （ P 〈 0. 05 ） ; Compared with control group, RVEDD increased and LVEDD decreased in ASD patients after percutaneous closure （P 〈 0. 05 ） . Compared with control group and patients who had received percutaneous closure, PSLS in each segment of free wall, PSLS in apical segment of septal wall and global PSLS before percutaneous closure were significantly increased （ P 〈 0.05 ） . To predict unfavorable outcome after percutaneous closure, the optimal cut - off value for PSLS at apical free wall site was -22. 3%, sensitivity was 82. 9%, specificity was 75.0%. Conclusion STI can be used to quantitatively evaluate right ventricular function before and after percutaneous closure, and PSLS of right ventricle can predict unfavorable out- come after percutaneous closure.

关 键 词：斑点追踪显像 房间隔缺损 心室功能 右 

分 类 号：R541.11[医药卫生—心血管疾病]