斑点追踪成像评价慢性重度主动脉瓣关闭不全患者右心室收缩功能  

Evaluation of right ventricular systolic function by speckle tracking imaging in patients with chronic and severe aortic regurgitation

作　　者：穆凯迪斯·赛米 关丽娜[1] 穆玉明[1] Mukaidisi Saimi;Guan Lina;Mu Yuming(Department of Echocardiography,the First Affiliated Hospital of Xinjiang Medical University,Xinjiang Key Laboratory of Ultrasound Medicine,Urumqi 830011,China)

机构地区：[1]新疆医科大学第一附属医院心脏超声诊断科、新疆超声医学重点实验室,乌鲁木齐830011

出　　处：《中华超声影像学杂志》2024年第4期288-293,共6页Chinese Journal of Ultrasonography

基　　金：国家自然科学基金(32071459)。

摘　　要：目的应用斑点追踪成像技术评价慢性重度主动脉瓣关闭不全(AR)患者右心室形态、功能及心肌力学的变化特点。方法回顾性选取2019年12月至2021年6月于新疆医科大学第一附属医院就诊的AR患者30例作为AR组,同期30例性别和年龄相匹配的健康志愿者作为对照组。采用彩色多普勒超声心动图测量右心房左右径(RAD)、右心室基底段左右径(RVD)、三尖瓣环收缩期位移(TAPSE)、右心室面积变化分数(RVFAC)、三尖瓣环收缩期峰值速度(S′)及右心室做功指数(RIMP)。通过斑点追踪技术获取右心室整体纵向应变(RVGLS)及各节段(右心室游离壁和室间隔的基底段、中间段和心尖段)的应变数据。比较AR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RVGLS、右心室游离壁纵向应变(RVFW-LS)与室间隔及各节段应变参数之间的相关性。结果①AR组RAD、RVD、RIMP、LAD高于对照组,RVFAC、TAPSE、S′、LVEF低于对照组,差异有统计学意义(均P<0.05);②与对照组相比,AR组RVGLS、RVFW-LS、右心室间隔长轴应变(RVSLS)及各节段应变明显降低,差异有统计学意义(均P<0.05)。③RVGLS与RVSLS、右心室室间隔基底段应变(RVSBS)呈正相关(r=0.38、0.40,均P<0.05)。结论重度AR可引起右心室各节段收缩功能障碍,包括整体和局部。Objective To evaluate the changes of right ventricular(RV)morphology,function,and myocardial mechanics in patients with severe chronic aortic regurgitation(AR)by speckle tracking imaging technology.Methods A total of 30 AR patients who were treated in the First Affiliated Hospital of Xinjiang Medical University from December 2019 to June 2021 were retrospectively selected as the AR group,and 30 healthy persons matched with sex and age in the same period were selected as the control group.The right atrial diameter(RAD),right ventricular basal diameter(RVD),tricuspid annular plane systolic excursion(TAPSE),right ventricular fractional area change(RVFAC),tricuspid annular peak systolic velocity(S′),and right ventricular index of myocardial performance(RIMP)were measured by color Doppler echocardiography.Speckle tracking technology was used to obtain global longitudinal strain(RVGLS)of the right ventricle and strain of each segment(free wall and interventricular septum at the basal,mid,and apical segments).The differences of the above parameters between the AR group and the control group were compared.Pearson linear correlation analysis was used to evaluate the correlation between RVGLS,right ventricular free wall longitudinal strain(RVFW-LS)and interventricular septum and strain parameters of each segment.Results①RAD,RVD,RIMP and LAD were higher in the AR group compared to the control group,while RVFAC,TAPSE,S′and LVEF were lower in the AR group(all P<0.05).②Compared to the control group,the AR group showed significantly decreased RVGLS,right ventricular free wall longitudinal strain(RVFW-LS),right ventricular septal longitudinal strain(RVSLS),and strain in each segment(all P<0.05).③RVGLS showed positive correlations with RVSLS,right ventricular septal basal segment strain(RVSBS)(r=0.38,0.40,all P<0.05).Conclusions Severe AR can cause functional impairments in different segments of the right ventricle,both globally and locally.

关 键 词：超声心动描记术 斑点追踪成像 主动脉瓣关闭不全 心室功能 右 

分 类 号：R543.1[医药卫生—心血管疾病] R445.1[医药卫生—内科学]