超声评价中重度功能性二尖瓣反流患者二尖瓣几何形态改变及其与左心室重构的相关性研究  

Echocardiographic Evaluation of Mitral Valve Geometry and Its Correlation with Left Ventricular Remodeling in Patients with Moderate to Severe Mitral Regurgitation

作　　者：聂淑婷 周畅[1] 邵袁缘 胡文姝 李心怡 谌典 张奥懿 Nie Shuting;Zhou Chang;Shao Yuanyuan;Hu Wenshu;Li Xinyi;Shen Dian;Zhang Aoyi(The First Clinical Medical School of China Three Gorges University/Department of Ultrasound,Yichang Central 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

出　　处：《中国超声医学杂志》2024年第5期536-540,共5页Chinese Journal of Ultrasound in Medicine

摘　　要：目的运用实时三维经食管超声心动图(RT-3D-TEE)评估中重度功能性二尖瓣反流(FMR)患者二尖瓣结构功能改变,探讨FMR加重的危险因素及不同程度FMR患者二尖瓣几何形态改变与左心室重构的相关性分析。方法选取70例心房颤动患者,根据二尖瓣反流程度分为心房颤动合并轻度功能性二尖瓣反流组40例(MR1组)及合并中重度功能性二尖瓣反流组30例(MR2组)。同期另选取40例窦性心律者作为对照组。分析二尖瓣瓣环参数和各项左心室功能参数。Logistic回归分析得到影响FMR程度加重的危险因素,比较左心室重构指标与二尖瓣瓣环参数之间的相关性。结果左心室整体旋转角度峰值(LVPtw)和二尖瓣瓣环左右径(AL-PM)是FMR程度加重的危险因素,相关性分析显示LVPtw与AL-PM、对合径线(CC)及瓣环面积(AA)负相关(P<0.05)。结论三维超声可定量评价心房颤动患者二尖瓣及左心室结构功能变化,左心室功能受损与FMR进展及二尖瓣重塑有关。Objective To evaluate the changes of mitral valve structure and function in patients with moderate to severe functional mitral regurgitation(FMR)by real-time three-dimensional transesophageal echocardiography,and to explore the risk factors of aggravation of FMR and the correlation between mitral valve geometry and left ventricular remodeling in patients with different degrees of FMR.Methods According to the degree of mitral regurgitation,70 patients with atrial fibrillation were divided into mild functional mitral regurgitation group(MR1 group,n=40)and moderate to severe functional mitral regurgitation group(MR2 group,n=30).In the same period,another 40 patients with sinus rhythm were selected as the control group.Mitral annulus parameters and left ventricular function parameters were analyzed.The risk factors affecting the aggravation of FMR were obtained by Logistic regression,and the correlation between left ventricular remodeling index and mitral annulus parameters was compared.Results Left ventricular peak twist(LVPtw)and anterolateral to poster medial diameter(AL-PM)were the risk factors for the aggravation of FMR.Correlation analysis showed that LVPtw was negatively correlated with AL-PM,commissural diameter(CC)and annulus area(AA)(P<0.05).Conclusions Three-dimensional echocardiography can quantitatively evaluate the structural and functional changes of mitral valve and left ventricular in patients with atrial fibrillation,impaired left ventricular function is associated with FMR progression and mitral valve remodeling.

关 键 词：实时三维经食管超声心动图 三维斑点追踪超声心动图 心房颤动 二尖瓣 左心室重构 

分 类 号：R54[医药卫生—心血管疾病]