四维自动右心室定量分析技术评价扩张型心肌病患者右心室功能  

Value of four-dimensional automatic right ventricular quantitative analysis in evaluating right ventricular function in patients with dilated cardiomyopathy

作　　者：杨曼曼 崔存英 张瑞[1] 王烁晶 刘瑞杰[1] 赵庆庆 董怡麟 刘琳[1] Yang Manman;Cui Cunying;Zhang Rui;Wang Shuojing;Liu Ruijie;Zhao Qingqing;Dong Yilin;Liu Lin(Department of Ultrasound,Fuwai Central China Cardiovascular Hospital of Zhengzhou University,Henan Key Laboratory of Cardiovascular Ultrasound Clinical and Basic Research,Zhengzhou 451464,China)

机构地区：[1]郑州大学华中阜外医院超声科、河南省心血管超声临床和基础研究医学重点实验室,郑州451464

出　　处：《中华超声影像学杂志》2023年第6期485-492,共8页Chinese Journal of Ultrasonography

基　　金：国家自然科学基金(82071950);河南省自然科学基金优秀青年科学基金(202300410364);河南省科技研发计划联合基金(222301420014)。

摘　　要：目的应用四维自动右心室定量分析(4D Auto RVQ)技术评价扩张型心肌病(DCM)患者右心室功能,并与心脏磁共振右心室射血分数(CMR-RVEF)对比,探讨4D Auto RVQ技术评价DCM患者右心室功能的应用价值。方法前瞻性选取2022年3-10月在郑州大学华中阜外医院就诊的DCM患者52例作为DCM组,同期选取52例健康志愿者作为对照组。所有入选者均行常规超声心动图检查,并应用4D Auto RVQ技术获取其四维右心室射血分数(4D-RVEF)、右心室每博量指数(RVSVI)、右心室舒张末期容积指数(RVEDVI)、右心室收缩末期容积指数(RVESVI)、四维右心室基底部内径(4D-RVDd-base)、四维右心室中间段内径(4D-RVDd-mid)、四维右心室长轴内径(4D-RVLd)、四维三尖瓣环收缩期位移(4D-TAPSE)、四维右心室面积变化分数(4D-RVFAC)。比较DCM组与对照组之间以上参数的差异。应用Pearson线性相关分析评价超声心动图参数与CMR-RVEF的相关性。应用ROC曲线寻找评价右心室功能最敏感的参数,计算ROC曲线下面积(AUC),并进行两两比较。结果与对照组相比,DCM组RVEDVI、RVESVI、4D-RVDd-base及4D-RVDd-mid增大,4D-RVEF、4D-TAPSE、4D-RVFAC、右心室整体纵向应变(RVGLS)及右心室游离壁纵向应变(RVFWLS)的绝对值减小(均P<0.05);两组间RVSVI、4D-RVLd差异无统计学意义(均P>0.05)。相关性分析显示4D-RVEF与CMR-RVEF呈正相关(r=0.711,P<0.05)。ROC曲线分析显示4D-RVEF评价DCM患者右心室功能的效能优于其他参数(AUC:0.916)。结论4D Auto RVQ技术可以定量评价DCM患者右心室功能,4D-RVEF与CMR-RVEF具有显著相关性,且4D-RVEF评价DCM患者右心室功能的效能最佳。Objective To evaluate the right ventricular function in patients with dilated cardiomyopathy(DCM)by four-dimensional automatic right ventricular quantitative analysis(4D Auto RVQ),and compare with the right ventricular ejection fraction measured by cardiac magnetic resonance(CMR-RVEF),and to explore the clinical application value of 4D Auto RVQ technique in evaluating the right ventricular function of patients with DCM.Methods A prospective study was conducted to select 52 patients with DCM who were treated in Fuwai Central China Cardiovascular Hospital of Zhengzhou University from March to October 2022 as DCM group,and 52 healthy volunteers were selected as the control group during the same period.The four-dimensional right ventricular ejection fraction(4D-RVEF),right ventricular stroke volume index(RVSVI),right ventricular end-diastolic volume index(RVEDVI),right ventricular end-systolic volume index(RVESVI),four-dimensional right ventricular basal diameter(4D-RVDd-base),four-dimensional right ventricular middle diameter(4D-RVDd-mid),four-dimensional right ventricular long axis diameter(4D-RVLd),four-dimensional tricuspid annular plane systolic excursion(4D-TAPSE)and four-dimensional right ventricular fractional area change(4D-RVFAC)were obtained by 4D Auto RVQ technique.The differences of the above parameters between DCM group and control group were compared.Pearson linear correlation analysis was used to evaluate the correlation between echocardiographic parameters and CMR-RVEF.The ROC curve was used to find the most sensitive parameters for evaluating right ventricular function,and the area under the ROC curve(AUC)was calculated and compared.Results Compared with the control group,RVEDVI,RVESVI,4D-RVDd-base and 4D-RVDd-mid in the DCM group were increased,and the absolute values of 4D-RVEF,4D-TAPSE,4D-RVFAC,right ventricular global longitudinal strain(RVGLS)and right ventricular free wall longitudinal strain(RVFWLS)were decreased(all P<0.05).Correlation analysis showed that 4D-RVEF was positively correlated w

关 键 词：四维自动定量技术 扩张型心肌病 心室功能 右 心脏磁共振 

分 类 号：R445.1[医药卫生—影像医学与核医学] R542.2[医药卫生—诊断学]