实时三维超声心动图评价急性下壁心肌梗死患者右心房容积及功能  

Evaluation of Right Atrial Volumes and Functions By Real-time Three-dimensional Echocardiography in Patients After Acute Inferior Myocardial Infarction

作　　者：彭雪莲 梁杉 刘洁 李明星 Peng Xuelian;Liang Shan;Liu Jie;Li Mingxing(Department of Ultrasound,Affiliated Hospital of Southwest Medical University,Luzhou,Sichuan 646000,China)

机构地区：[1]西南医科大学附属医院超声科

出　　处：《中国超声医学杂志》2019年第10期904-907,共4页Chinese Journal of Ultrasound in Medicine

摘　　要：目的应用实时三维超声心动图(RT-3DE)评价急性下壁心肌梗死(IMI)伴或不伴右室心肌梗死(RVMI)患者右心房容积及功能变化。方法将44例IMI患者分为单纯IMI组(29例)和IMI+RVMI组(15例),另选择30例冠脉造影结果阴性者为对照组。采用RT-3DE测量右心房各相容积,经体表面积校正得到各容积指数(RAVmaxI、RAVpreI、RAVminI),计算右心房总排空指数(TSVI)、被动排空指数(PSVI)、主动排空指数(ASVI)、扩张指数(EI)、总排空分数(TEF)、被动排空分数(PEF)、主动排空分数(AEF)。结果与对照组及IMI组比较,IMI+RVMI组右心房各相容积指数均增大,PEF减低,差异具有统计学意义(P<0.05)。对右心房容积指数做ROC分析,RAVmaxI曲线下面积最大(AUC=0.894,P=0.000),以30.45ml/m^2为截点,预测IMI伴RVMI的灵敏度为80%、特异度为89.7%。结论IMI伴RVMI患者右心房各相容积均增大,管道功能降低,存储功能及泵功能无明显变化。RT-3DE测量的RAVmaxI可作为预测IMI是否伴RVMI的一项替代指标。Objective To evaluate the changes of right atrial phase volumes and functions in patients with acute inferior wall myocardial infarction(IMI)with or without right ventricular myocardial infarction(RVMI).Methods 44 consecutive patients with acute inferior myocardial infarction were divided into IMI group(29 cases)and IMI+RVMI group(15 cases),and 30 patients with normal coronary angiography results were selected as the control group.Right atrium phase volume was evaluated by RT-3 DE,volume index(RAVmaxI,RAVpreI,RAVminI)was obtained after the correction of body surface area,calculating the total right atrium emptying index(TSVI),passive emptying index(PSVI),active emptying index(ASVI),the expansion index(EI),total emptying fraction(TEF),passive emptying fraction(PEF),active emptying fraction(AEF).Results Compared with the control group and the IMI group,the phase volume index of right atrium in the IMI+RVMI group increased and the passive emptying function decreased,with statistically significant difference(P<0.05).ROC analysis was performed on the right atrial volume index,the area under the ROC curve of RAVmaxI was the biggest(AUC=0.894,P=0.000).If 30.45 ml/m^2 as selected as the cut-off point to predict IMI with RVMI,the sensitivity was 80%and the specificity was 89.7%.Conclusions Right ventricle involvement may cause an increase in right atrial phase volumes and deterioration of conduit function in patients with IMI.RAVmaxI measured by RT-3DE might serve as a surrogate endpoint for determining whether IMI is accompanied by RVMI.

关 键 词：三维超声心动图 右心房 急性下壁心肌梗死 右室心肌梗死 

分 类 号：R445.1[医药卫生—影像医学与核医学] R542.22[医药卫生—诊断学]