应变及应变率成像评价房间隔缺损患者封堵术后右心室功能变化  

Assessment of right ventricular function by strain and strain rate imaging after transcatheter closure of atrial septal defect

作　　者：刘娟[1] 倪锐志[1] 包凡[2] 白文伟[1] 李敬[1] 宋蕊[1] LIU Juan;NI Ruizhi;BAO Fang;BAI Wenwei;LI Jing;SONG Rui(Department of Ultrasound,the Second Affiliated Hospital of Kunming Medical University,Kunming,Yunnan 650000,China;Stomatological Center, Yunnan First People′s Hospital,Kunming,Yunnan 650000,China)

机构地区：[1]昆明医科大学第二附属医院超声科,650000 [2]云南省第一人民医院口腔医学中心,昆明650000

出　　处：《重庆医学》2019年第11期1887-1890,共4页Chongqing medicine

摘　　要：目的通过应变、应变率成像及超声心动图量化分析房间隔缺损患者介入封堵术后右房室大小、右心室功能及心肌收缩性的变化。方法选取33例先天性心脏病继发孔中央型房间隔缺损(ASD)并行封堵术患者作为病例组,健康志愿者20例作为对照组,对照组及病例组术前1d、术后3d及3个月行常规超声心动图检查及应变、应变率成像分析,比较各参数在封堵术前后的变化。结果(1)病例组右心室侧壁收缩期达峰应变、应变率值均高于对照组(P<0.05);术后3d、3个月较术前改变不明显(P>0.05)。(2)右房、右心室内径术后3d、3个月均较术前缩小(P<0.05)。(3)主肺动脉内径术后3个月较术前、术后3d均缩小(P<0.05);肺动脉收缩压术后3d及3个月均较术前降低(P<0.05),但术后3个月与术后3d相比下降不明显(P>0.05)。(4)右心室射血分数(RVEF)术后3d较术前减小(P<0.05),但术后3个月与术后3d比较减小不明显(P>0.05)。结论房间隔缺损封堵治疗矫正了右心容量负荷的增多,右心结构逐步改善,肺动脉收缩压下降,右心室心肌收缩力保持不变。Objective Study quantitatively alteration of the regional myocardial contractility,right heart dimension as well as systolic function of 33 ASD patients suffered from transcatheter closure via echocardiography,strain and strain rate imaging. Methods Selected cases of congenital heart disease of secundum type ASD patients underwent central catheter occlusion in thirty cases,the control group of twenty healthy volunteers were selected,routine echocardiography examination and analysis by strain and strain rate imaging were applied for the ASD goup and control one to compare change of image-parameter before and after transcatheter closure. Results (1)Compared with the control group,the peak systolic strain and strain rate of right ventricular wall of ASD group rised up dramatically ( P <0.05),However,alteration in post-operative 3 days and 3 monthes is not distinct ( P >0.05).(2)Diameters of RA and RV are both lessen than that of pre-operative ones ( P <0.05).(3)Diameters of pulmonary trunk are both lessen than than that of pre-operative ones ( P <0.05),SPAP (systolic pulmonary artery) pressure of patients at post-operative 3 days and 3 monthes is also declined compared with that of pre-operartive ones,but the difference between that of post-operative 3 days and 3 monthes is not significant( P >0.05).(4)REVF(Right ventricular ejection fraction)at post-operative 3 days is lessen than than that of pre-operation( P <0.05),but the difference between that of post-operative 3 days and 3 monthes is not significant( P >0.05). Conclusion Transcatheter closure to ASD can remedy volume overloading of right heart,improve gradually constructure of right heart,and contribute to decline of SPAP.however,the peak systolic strain and strain rate of interventricular septal and right ventricular wall of ASD experience little change after transcatheter closure,indicating that myocardial contractility of Right ventricular remains unchanged after transcatheter closure to ASD.

关 键 词：房间隔缺损 超声心动图 应变 应变率 

分 类 号：R542.22[医药卫生—心血管疾病]