全自动三维超声右心室定量评价慢性肺源性心脏病患者右室收缩功能  

Evaluation of right ventricular systolic function by fully automated three-dimensional echocardiography right ventricular quantification software in patients with chronic pulmonary heart disease

作　　者：王爽 冯艳红 WANG Shuang;FENG Yanhong(Department of Medical Ultrasonics,The First Affiliated Hospital of Jinzhou Medical University,Jin-zhou 121001,China)

机构地区：[1]锦州医科大学附属第一医院超声医学科,辽宁锦州121001

出　　处：《实用医学杂志》2022年第19期2476-2480,共5页The Journal of Practical Medicine

基　　金：辽宁省自然科学基金计划重点项目(编号:20180530009)。

摘　　要：目的探讨全自动三维超声右心室定量(3D Auto RV)评估慢性肺源性心脏病(CPHD)患者右室收缩功能的临床价值。方法根据临床表现将88例CPHD患者分为代偿组(48例)和失代偿组(40例),另选取健康对照组40例。测量受试者常规超声参数,并应用3D Auto RV测量右室舒张末期容积(RVEDV)、右室收缩末期容积(RVESV)、右室每搏输出量(RVSV)、右室射血分数(RVEF)、三尖瓣环收缩期位移(TAPSE)、右室面积变化率(RVFAC)、右室的游离壁纵向应变(FWLS)和室间隔纵向应变(SLS),比较各组间差异。结果(1)与对照组比较,CPHD各组TAPSE、RVFAC、RVEF、FWLS及SLS均减低,RVEDV、RVESV均增大(P<0.05);失代偿组RVSV较对照组及代偿组均减低(P<0.05),代偿组RVSV与对照组比较无明显差异(P>0.05)。与代偿组相比,失代偿组TAPSE、RVFAC、RVEF及FWLS均进一步减低,RVEDV、RVESV均进一步增大(P<0.05),RVSLS差异无统计学意义(P>0.05)。(2)FWLS与RVEF相关性较高(r=-0.721,P<0.001)。(3)RVEF预测CPHD失代偿期的最佳截断值为41.35%(AUC=0.95,P<0.001)。(4)重复性检验显示RVEF和FWLS具有良好的重复性。结论3D Auto RV能够准确评价CPHD患者的右室收缩功能,有望成为临床评估CPHD患者病情程度的新方法。Objective To investigate the clinical value of fully automated three-dimensional echocardiography right ventricular quantification software(3D Auto RV)in evaluating right ventricular systolic function in patients with chronic pulmonary heart disease(CPHD).Methods According to clinical manifestations,88 patients with CPHD were divided into the compensated group(n=48)and the decompensated group(n=40),and 40 healthy subjects served as controls.To measure the routine ultrasound parameters of the subjects,and apply 3D Auto RV measures right ventricular end-diastolic volume(RVEDV),right ventricular end-systolic volume(RVESV),right ventricular stroke volume(RVSV),right ventricular ejection fraction(RVEF),tricuspid annular plane systolic excursion(TAPSE),right ventricular fractional area change(RVFAC),longitudinal strain of free wall(FWLS),longitudinal strain of ventricular septum(SLS),and the difference among groups were compared.Results(1)Compared with the control group,TAPSE,RVFAC,RVEF,FWLS and SLS were decreased,while RVEDV and RVESV were increased in CPHD groups(P<0.05).The RVSV of the decompensated group was significantly lower than that of the control group and the compensated patients(P<0.05),but there was no sig-nificant difference between the compensatory group and the control group(P>0.05).Compared with the compensated group,TAPSE,RVFAC,RVEF and FWLS were further decreased,RVEDV and RVESV were further increased in the decompensated group(P<0.05),and SLS had no significant difference(P>0.05).(2)FWLS had a high correlation with RVEF(r=-0.721,P<0.001).(3)The optimal cut-off value of RVEF for predicting the decompensated phase of CPHD was 41.35%(AUC=0.95,P<0.001).(4)Repeatability test showed that both RVEF and FWLS had good repeatability.Conclusion 3D Auto RV can accurately evaluate the right ventricular systolic function in patients with CPHD,which is expected to become a new method for clinical evaluation of the severity of CPHD.

关 键 词：三维超声右心室定量 慢性肺源性心脏病 右心室功能 人工智能 

分 类 号：R445.1[医药卫生—影像医学与核医学] R541.5[医药卫生—诊断学]