实时三维超声心动图评估三尖瓣下移畸形解剖矫治术后右室重构的临床价值  

Clinical value of real-time three-dimensional echocardiography in evaluating right ventricular remodeling after correction of Ebstein anomaly

作　　者：刘倩倩 葛滨 李静惠 万琳媛 王婧金 孟红 LIU Qianqian;GE Bin;LI Jinghui;WAN Linyuan;WANG Jingjin;MENG Hong(Department of Echocardiography,Fuwai Hospital,National Center for Cardiovascular Diseases,Chinese Academy of Medical Sciences and Peking Union Medical College,Beijing 100037,China)

机构地区：[1]中国医学科学院阜外医院超声影像中心,北京市100037 [2]中国医学科学院阜外医院磁共振影像科,北京市100037

出　　处：《临床超声医学杂志》2024年第6期454-459,共6页Journal of Clinical Ultrasound in Medicine

基　　金：中国医学科学院临床与转化医学研究专项(2022-I2M-C&T-B-051);云南省阜外心血管病临床医学中心项目(FZX2019-06-01-09)。

摘　　要：目的探讨实时三维超声心动图(RT-3DE)评估三尖瓣下移畸形(EA)解剖矫治术后右室重构的临床应用价值。方法选取在我院行外科解剖矫治术的22例EA患者,根据Carpentier分型分为A-B型组(10例)、C型组(6例)和D型组(6例),比较各组术前和术后6个月RT-3DE及心脏磁共振(CMR)检查结果的差异。采用Pearson相关分析法分析RT-3DE与CMR所测右室舒张末容积指数(RVEDVi)及右室射血分数(RVEF)的相关性。结果RT-3DE检查显示,各组术前左室射血分数、RVEF及术后6个月RVEF比较差异均有统计学意义(均P<0.05);22例EA患者术后6个月三尖瓣反流程度较术前减轻,RVEF和RVEDVi均减小,差异均有统计学意义(均P<0.05)。CMR检查显示,22例EA患者术后6个月RVEDVi较术前减小,差异有统计学意义(P<0.05)。相关性分析显示,术前RT-3DE与CMR所测RVEDVi呈高度正相关(r=0.908,P=0.012),两种方法所测术后RVEDVi无相关性(r=0.522,P=0.184);RT-3DE与CMR所测术前和术后RVEF分别呈高度、中度正相关(r=0.818、0.564,均P<0.05)。结论RT-3DE可准确评估EA患者右室容积和功能,在术后右室重构评估中具有重要的临床应用价值。Objective To investigate the clinical application value of real-time three-dimensional echocardiography(RT-3DE)in the evaluation of right ventricular remodeling after correction of Ebstein anomaly(EA).Methods A total of EA patients who underwent surgical anatomical correction in our hospital were selected,according to the Carpentier classification,they were divided into type A-B group(10 cases),type C group(6 cases)and type D group(6 cases).The differences of RT-3DE and cardiac magnetic resonance(CMR)findings among groups before operation and 6 months after operation were compared.Pearson correlation analysis was used to analyze the relationship between right ventricular diastolic end volume index(RVEDVi)and right ventricular ejection fraction(RVEF)measured by RT-3DE and CMR.Results RT-3DE show that there were statistically significant differences in left ventricular ejection fraction(LVEF)and RVEF before operation and RVEF at 6 months after operation among groups(all P<0.05).Compared with the preoperative results,the degree of tricuspid regurgitation,RVEF and RVEDVi were decreased in 22 EA patients 6 months after operation,and the differences were statistically significant(all P<0.05).CMR showed that the RVEDVi was decreased in 22 EA patients 6 months after operation compared with the preoperative results,there was statistically significant difference(P<0.05).The correlation analysis showed that the RT-3DE value of preoperative RVEDVi was highly positively correlated with the CMR value(r=0.908,P=0.012),but there was no correlation between the two methods of postoperative RVEDVi(r=0.522,P=0.184),the RT-3DE value of preoperative and postoperative RVEF were highly and moderately positively correlated with the CMR value(r=0.818,0.564,both P<0.05).Conclusion RT-3DE could accurately evaluate the right ventricular volume and function in EA patients,and has important clinical application value in the evaluation of postoperative right ventricular remodeling.

关 键 词：超声心动描记术 三维 实时 三尖瓣下移畸形 心脏磁共振 右室重构 

分 类 号：R540.45[医药卫生—心血管疾病]