超声评价二尖瓣脱垂患者左房重构与病理纤维化的相关性分析  

Correlation Between Left Atrial Remodeling and Pathological Fibrosis in Patients with Mitral Valve Prolapse Evaluated by Echocardiography

作　　者：许涛 周畅[1] 张松林[2] 吴辉[3] 杨欣[4] 徐亮[1] 孙恒 Xu Tao;Zhou Chang;Zhang Songlin;Wu Hui;Yang Xin;Xu Liang;Sun Heng(Department of Ultrasound,The First Clinical Medical Science College of China Three Gorges University&Yichang Central People’s Hospital,Yichang,Hubei 443000,China;Department of Cardiothoracic Surgery,The First Clinical Medical Science College of China Three Gorges University&Yichang Central People’s Hospital,Yichang,Hubei 443000,China;Department of Cardiorascular Medicine,The First Clinical Medical Science College of China Three Gorges University&Yichang Central People’s Hospital,Yichang,Hubei 443000,China;Department of Cardiothoracic Surgery,The Second People’s Hospital of China Three Gorges University&Yichang Second People’s Hospital,Yichang,Hubei 443000,China)

机构地区：[1]三峡大学第一临床医学院宜昌市中心人民医院超声科,湖北省宜昌市443000 [2]三峡大学第一临床医学院宜昌市中心人民医院胸心外科,湖北省宜昌市443000 [3]三峡大学第一临床医学院宜昌市中心人民医院心血管内科,湖北省宜昌市443000 [4]三峡大学附属第二人民医院宜昌市第二人民医院胸心外科,湖北省宜昌市443000

出　　处：《中国超声医学杂志》2023年第5期506-510,共5页Chinese Journal of Ultrasound in Medicine

摘　　要：目的探讨实时三维超声心动图(RT-3DE)与二维斑点追踪技术(2D-STI)评价的二尖瓣脱垂(MVP)患者的左房构型参数、功能参数及左房僵硬度指数(LASI)与左心房心肌纤维化病理特征之间的相关性。方法纳入行二尖瓣置换术的重度MVP患者35例及30例健康体检者。应用RT-3DE和2D-STI评估左房容积及功能参数并计算获得LASI。MVP患者术中留取左房心肌标本,镜检分析获得细胞外容积分数(ECV),分析两组间数据有无差异,并对MVP患者左房容积、功能参数及LASI与ECV之间进行相关性分析。结果①MVP组的容积参数及LASI均高于对照组,左房被动排空分数(LAPEF)、峰值纵向应变(PALS)、左房管道期应变(LAScd)低于对照组,差异均具有统计学意义(P<0.05)。②相关性分析显示MVP组的LASI与ECV呈正相关,且相关系数最高(P<0.05)。结论RT-3DE和2D-STI技术联合LASI能评价重度MVP患者的左房构型及功能改变,其中LASI与左房心肌纤维化改变的程度呈正相关,且相关性最高。Objective To investigate the correlation between left atrial configuration parameters,functional parameters,left atrial stiffness index(LASI)and pathological features of left atrial myocardial fibrosis in patients with severe mitral valve prolapse(MVP)evaluated by real-time three-dimensional echocardiography(RT-3DE)and two-dimensional speckle tracking imaging(2D-STI).Methods A total of 35MVP patients who underwent mitral valve replacement and 30healthy people were included.RT-3DE and 2D-STI were used to evaluate left atrial volume and functional parameters and calculate LASI.During the operation,left atrial myocardium samples were taken from MVP patients.Extracellular volume fraction(ECV)was obtained by microscopic analysis.The difference between the two groups was analyzed.The correlation between left atrial volume,functional parameters,LASI and ECV was analyzed.Results①The volume parameters and LASI of the MVP group were higher than those of the control group,while LAPEF,PALS and LAScd of the MVP group were lower than those of the control group(P<0.05).②Correlation analysis showed that there was a positive correlation between LASI and ECV in the MVP group(P<0.05)and the correlation coefficient was the highest.Conclusions RT-3DE and 2D-STI combined with LASI can evaluate the changes of left atrial configuration and function in patients with severe MVP.LASI is positively correlated with the degree of left atrial myocardial fibrosis,and the correlation coefficient is the highest.

关 键 词：超声心动图 二尖瓣脱垂 二维斑点追踪 左房僵硬度 心肌纤维化 无创 

分 类 号：R445.1[医药卫生—影像医学与核医学] R542.51[医药卫生—诊断学]