三维经食管超声自动二尖瓣定量技术评价心房颤动患者二尖瓣环形变规律的研究  

Evaluation of mitral annulus changes in patients with atrial fibrillation by automated software 4D-MVA with three-dimensional transesophageal echocardiography

作　　者：李萌[1] 王雪琦 李浩玥 刘硕 马春燕[1] LI Meng;WANG Xueqi;LI Haoyue;LIU Shuo;MA Chunyan(Department of Cardiovascular Ultrasound,the First Hospital of China Medical University,Shenyang,110002,China)

机构地区：[1]中国医科大学附属第一医院心血管超声科,沈阳110002

出　　处：《临床心血管病杂志》2024年第12期967-971,共5页Journal of Clinical Cardiology

摘　　要：目的:通过三维经食管超声(3D-TEE)二尖瓣自动定量技术(4D-MVA)评价心房颤动(AF)患者二尖瓣环的变化。方法:前瞻性纳入AF患者61例,其中轻度及中度二尖瓣反流AF患者24例(AFMR+组)、无二尖瓣反流AF患者(AFMR-组)37例,对照组24例,均行3D-TEE检查,并采用4D-MVA获取二尖瓣环系列参数,进行比较分析。结果:与对照组比较,AF患者二尖瓣环前后径(AP)、瓣环面积(AA)更大,瓣环高度(AH)更低,瓣环圆度(AS)更圆,非平面角度(NPA)更大(均P<0.05);在AF患者中,AFMR+组舒张末期AS更接近1,收缩末期和舒张末期AA更大,AH更低(均P<0.05)。此外,AFMR+组AP、AS、AH和AA收缩期变化率较对照组及AFMR—组均减小(P<0.05),而AFMR—组与对照组AP、AS、AH、AA收缩期变化率无显著差异。结论:AF患者二尖瓣环扩大,趋向圆形、平坦,且合并二尖瓣反流的AF患者二尖瓣环变化更显著,随心动周期动态变化也更显著。Objective:To evaluate the mitral annulus changes in atrial fibrillation(AF)patients through automated 4D-MVA software with three-dimensional transesophageal echocardiography(3D-TEE).Methods:We prospectively enrolled 24 AF patients with mild or moderate mitral regurgitation as AFMR+group,37 AF patients without mitral regurgitation as AFMR-group,and 37 cases as control group.3D-TEE was performed to obtain mitral apparatus parameters by 4D-MVA software for analysis.Results:The anterior to posterior diameter(AP)and area(AA)of mitral annulus were larger in AFMR-group and AFMR+group,the height of mitral annulus(AH)was lower,the sphericity of mitral annulus(AS)was rounder,and the nonplanarity angle(NPA)was larger,the differences were statistically significant(all P<0.05).Between the two AF groups,the end-diastolic AS in AFMR+group was rounder,the end-systolic and end-diastolic AA was higher,and the AH was lower,with statistical significance(all P<0.05).The systolic change rates of AP,AS,AH and AA in AFMR+group were lower than those in control group and AFMR-group(all P<0.05),but there was no significant difference between control group and AFMR-group.Conclusion:In AF patients,the mitral annulus was enlarged and tended to be round and flat.The remodeling of the mitral annulus in patients with AFMR+was more significant than that in patients with AFMR-.Patients with AFMR+had more damage to the dynamic changes of the mitral annulus throughout cardiac cycle.

关 键 词：二尖瓣 自动定量 心房颤动 经食管三维超声心动图 

分 类 号：R541.7[医药卫生—心血管疾病]