四维超声心动图评价扩张型心肌病右心室整体收缩功能及其临床意义  

Four-dimensional Echocardiography for Evaluation of Right Ventricular Systolic Function in Dilated Cardiomyopathy and Its Clinical Significance

作　　者：梁科研[1] 杨芳[1] 褚静洁[1] LIANG Keyan;YANG Fang;CHU Jingjie(Liaoning Anshan Central Hospital,Anshan 114001,Liaoning,China)

机构地区：[1]辽宁省鞍山市中心医院,辽宁鞍山114001

出　　处：《心血管病学进展》2020年第5期547-550,共4页Advances in Cardiovascular Diseases

基　　金：辽宁省教育厅科学研究一般项目(L2013698)。

摘　　要：目的探讨四维超声心动图评价扩张型心肌病(DCM)右心室整体收缩功能的意义。方法将本院2017年1月—2018年12月收治的68例DCM患者纳为研究对象,根据普通二维超声测量结果,将右心室内径扩大者纳为A组(n=33),右心室内径正常者纳为B组(n=35),并将同期行健康体检者纳为对照组(n=40),所有研究对象均行常规超声心动图检查并存储留取四维超声图像备分析,统计三组左心室内径、射血分数及右心室容积、射血分数,以及右心室总体应变参数[总体长轴峰值应变(GPSL)、总体圆周峰值应变(GPSC)、总体面积峰值应变(GPSA)和总体径向峰值应变(GPSR)],常规药物治疗4周后,比较DCM患者治疗前后右心室相关参数变化,评价四维超声心动图在评价DCM患者右心室收缩功能中的作用。结果三组左心室舒张期内径、左心室射血分数、右心室容积以及右心室射血分数均存在显著差异(P<0.05);三组GPSL、GPSC、GPSA以及GPSR水平差异显著(P<0.05);DCM患者治疗后,其三尖瓣峰值反流速度、右心室射血分数、GPSL、GPSC、GPSA和GPSR水平均较治疗前显著上升(P<0.05)。结论四维超声心动图能有效地提示DCM患者右心室微观变化,且即使是右心室内径正常的DCM患者,也具有右心室收缩功能障碍,应及时治疗以缓解右心室病变。Objective To explore the significance of four-dimensional echocardiography for the evaluation of right ventricular systolic function in dilated cardiomyopathy(DCM).Methods 68 patients with DCM admitted to the hospital from January 2017 to December 2018 were selected for the study.According to the results of ordinary two-dimensional ultrasound measurement,the patients with right ventricular diameter enlargement were classified as group A(n=33),and the patients with normal right ventricular diameter were included in group B(n=35),and the examiners who underwent healthy physical examination at the same time were set as control group(n=40).All subjects were examined by conventional echocardiography and stored for analysis of four-dimensional ultrasound images.The ventricular diameter,ejection fraction,right ventricular volume,ejection fraction,and right ventricular total strain parameters[global peak longitudinal strain(GPSL),global peak circumferential strain(GPSC),global peak area strain(GPSA),global peak radial strain(GPSR)]were counted in the three groups.The changes of right ventricular related parameters before and after treatment were also compared among DCM patients,and the effects of four-dimensional echocardiography in evaluating right ventricular systolic function in DCM patients were evaluated.Results There were significant differences in the left ventricular diastolic diameter,left ventricular ejection fraction,right ventricular volume and right ventricular ejection fraction among the three groups(P<0.05).There were significant differences in the levels of GPSL,GPSC,GPSA and GPSR among the three groups(P<0.05).After treatment in DCM patients,the tricuspid peak reversal flow velocity,right ventricular ejection fraction,GPSL,GPSC,GPSA and GPSR were significantly higher than before treatment(P<0.05).Conclusion Four-dimensional echocardiography can effectively indicate the microscopic changes of right ventricle in DCM patients,and even DCM patients with normal right ventricular diameter have obstacles in rig

关 键 词：四维超声心动图 扩张型心肌病 右心室整体收缩功能 临床意义 

分 类 号：R540.45[医药卫生—心血管疾病] R542.2[医药卫生—内科学]