左心室压力-应变环定量评价房间隔缺损封堵前后心肌做功变化  

Left ventricular pressure strain loops for quantitative evaluation on changes of myocardial work before and after interventional occlusion of atrial septal defect

作　　者：夏青青 袁新春[1] 胡佳[1] 冉洪玲 张哲元 曾曦 黄梅凤 XIA Qingqing;YUAN Xinchun;HU Jia;RAN Hongling;ZHANG Zheyuan;ZENG Xi;HUANG Meifeng(Department of Medical Ultrasound,the First Affiliated Hospital of Nanchang University,Nanchang 330006,China)

机构地区：[1]南昌大学第一附属医院超声医学科,江西南昌330006

出　　处：《中国医学影像技术》2022年第5期689-693,共5页Chinese Journal of Medical Imaging Technology

摘　　要：目的采用左心室压力-应变环(LV PSL)定量评估房间隔缺损(ASD)患者接受介入封堵术前后左心室心肌做功变化。方法纳入32例接受介入封堵术治疗的中央型ASD患者(ASD组)及30名健康成人(对照组),比较术前、术后2天和3个月ASD组与对照组、ASD组内各时间点二维超声心动图及LV PSL参数,包括左心室舒张末内径(LVEDD)、左心室收缩末期内径(LVESD)、左心室舒张末容积(LVEDV)、左心室整体纵向应变(GLS)、整体做功指数(GWI)、整体有用功(GCW)、整体无用功(GWW)及整体做功效率(GWE)等的差异;采用Bland-Altman分析法评价观察者内及观察者间测量GWI、GCW结果的一致性。结果ASD组术前LVEDD、LVESD、LVEDV、GLS、GWI及GCW均小于对照组(P均<0.05),术前其余参数及术后全部参数与对照组差异均无统计学意义(P均>0.05)。ASD组内,术后各时间点LVEDD、LVESD、LVEDV、GLS、GWI及GCW均大于术前(P均<0.05),而术后2天与3个月差异均无统计学意义(P均>0.05);其余参数各时间点间差异均无统计学意义(P均>0.05)。Bland-Altman分析结果显示,观察者内及观察者间测量GWI、GCW结果的一致性良好。结论LV PSL可无创量化ASD患者接受介入封堵术前后左心室整体心肌做功,有效评价术后左心室功能变化。Objective To observe the changes of left ventricular myocardial work before and after interventional occlusion of atrial septal defect(ASD)with left ventricular pressure strain loops(LV PSL).Methods Totally 32 patients with central type ASD who underwent interventional occlusion(ASD group)and 30 healthy adults(control group)were enrolled.The parameters of two-dimensional echocardiography and LV PSL,including left ventricular end-diastolic diameter(LVEDD),left ventricular end-systolic diameter(LVESD),left ventricular end-diastolic volume(LVEDV),global longitudinal strain(GLS),global work index(GWI),global constructive work(GCW),global waste work(GWW),global work efficiency(GWE)and so on before occlusion,2 days and 3 months after occlusion were compared between groups,also compared among different time points within ASD group.Bland-Altman analysis was used to evaluate the intra-observer and inter-observer consistency for measuring GWI and GCW.Results Before interventional occlusion,LVEDD,LVESD,LVEDV,GLS,GWI and GCW in ASD group were all lower than those in control group(all P<0.05),while there was no significant difference of the other pre-occlusion parameters nor all post-occlusion parameters between groups(all P>0.05).In ASD group,LVEDD,LVESD,LVEDV,GLS,GWI and GCW at each time points after occlusion were higher than those before(all P<0.05),but not significantly different between 2 days and 3 months after occlusion(all P>0.05),while no significant difference of other parameters was found at all time points(all P>0.05).Bland-Altman analysis showed good intra-observer and inter-observer agreement in measurements of GWI and GCW.Conclusion LV PSL could non-invasively quantify global myocardial work of left ventricle in ASD patients before and after interventional occlusion,therefore effectively evaluating changes of left ventricular function after occlusion.

关 键 词：房间隔缺损 心室 左 超声心动描记术 介入封堵术 压力-应变环 

分 类 号：R541[医药卫生—心血管疾病] R540.45[医药卫生—内科学]