不同分型BAV与主动脉扩张及左室构型关联的临床研究  

Clinical Study on the Relationship Between the Classification of Bicuspid Aortic Valve Malformation and Left Ventricular Geometry and Aorta

作　　者：任星星 段新 刘奇奇 孙泽亚 沈文茜 陈双[1] 杜国庆[1] Ren Xingxing;Duan Xin;Liu Qiqi;Sun Zeya;Shen Wenxi;Chen Shuang;Du Guoqing(Department of Ultrasound,The Second Affiliated Hospital of Harbin Medical University,Harbin 150086,China)

机构地区：[1]哈尔滨医科大学附属第二医院超声医学科,哈尔滨市150086

出　　处：《中国超声医学杂志》2022年第6期645-649,共5页Chinese Journal of Ultrasound in Medicine

摘　　要：目的探讨不同二叶或主动脉瓣畸形(BAV)分型的主动脉扩张模式及左室构型情况。方法回顾分析经超声心动图确诊的437例BAV患者,分析不同分型的BAV患者的主动脉扩张模式及左室构型差异。结果(1)患者基线及超声心动图数据情况:性别、BSA、LVMI及钙化在BAV 4种分型之间具有统计学意义(P<0.05),且1(L-R)型的LVMI高于其他3组。(2)BAV分型与左室构型的构成比率存在显著差异(P<0.05),使用降维对应分析法得到,在一个空间内,0型更倾向于正常构型,1(L-R)型更倾向于离心性肥厚,1(R-N)型更倾向于向心性肥厚,1(L-N)型更倾向于向心性重构。(3)在单部位主动脉扩张中,以1(R-N)型中的升主动脉扩张(31%)和1(L-N)型中的主动脉根部扩张(27%)最常见;在主动脉联合扩张中,以1(L-R)型中的升主动脉+主动脉根部联合扩张(31%)最常见。(4)4组左室几何构型的升主动脉最大直径有显著差异(P=0.015)。在左室几何构型组中,离心性肥厚和向心性肥厚患者的升主动脉最大直径显著大于其他两组(P<0.05)。结论不同BAV分型与主动脉扩张模式及左室构型之间存在联系,有助于临床评估BAV的进展以及早期干预BAV。Objective To investigate the aortic dilation pattern and left ventricular configuration of different bicuspid aortic valve(BAV)types.Methods 437 patients with BAV diagnosed by echocardiography were retrospectively analyzed,and the aortic dilation pattern and left ventricular configuration of different types of BAV patients were analyzed.Results(1)Baseline and echocardiographic data of patients:gender,BSA,LVMI and calcification had statistical significance among the four types of BAV(P<0.05),and LVMI of type 1(L-R)was higher than that of the other three groups.(2)There was a significant difference between BAV classification and left ventricular configuration(P<0.05).According to the dimensional-reduction correspondence analysis,0 type was more inclined to normal configuration,1(L-R)type was more inclined to eccentric hypertrophy,1(R-N)type was more inclined to centripetal hypertrophy,and 1(L-N)type was more inclined to centripetal remodeling in a space.(3)Among single aortic dilatation,ascending aortic dilatation of type 1(R-N)(31%)and aortic root dilatation of type 1(L-N)(27%)were the most common.Among the aortic dilatations,the ascending aorta+aortic root dilatation of type 1(L-R)was the most common(31%).(4)The maximum diameter of ascending aorta in left ventricular geometry was significantly different among the four groups(P=0.015).In the left ventricular geometry group,the maximum diameter of ascending aorta in patients with eccentric hypertrophy and centripetal hypertrophy was significantly larger than that in the other two groups(P<0.05).Conclusions Different BAV types are associated with aortic dilation and left ventricular configuration,which is helpful for clinical assessment of BAV progression and early intervention.

关 键 词：二叶式主动脉瓣畸形 左室几何构型 左室肥厚 主动脉扩张 

分 类 号：R540.45[医药卫生—心血管疾病] R542.52[医药卫生—内科学]