四维自动右室定量技术评价不同程度慢性心力衰竭患者右室功能的临床价值  

Clinical value of four-dimensional automatic right ventricular quantification technology in assessing right ventricular function in patients with different degree of chronic heart failure

作　　者：董怡麟 崔存英 杨曼曼 刘瑞杰[1] 赵庆庆 张瑞[1] 王烁晶 罗安琳 刘琳[2] DONG Yilin;CUI Cunying;YANG Manman;LIU Ruijie;ZHAO Qingqing;ZHANG Rui;WANG Shuojing;LUO Anlin;LIU Lin(Department of Ultrasound,Central China Fuwai Hospital of Zhengzhou University,Zhengzhou 451464,China;Department of Ultrasound,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China)

机构地区：[1]郑州大学华中阜外医院超声科,河南郑州451464 [2]郑州大学第一附属医院超声科,河南郑州450052

出　　处：《临床超声医学杂志》2025年第2期97-102,共6页Journal of Clinical Ultrasound in Medicine

基　　金：国家自然科学基金项目(82071950);河南省科技研发计划联合基金项目(222301420014)。

摘　　要：目的探讨四维自动右室定量(4D Auto RVQ)技术评价不同程度慢性心力衰竭(CHF)患者右室功能的临床价值。方法前瞻性选取在我院住院部确诊的CHF患者99例,依据6 min步行距离(6MWD)将其分为轻度CHF组(6MWD>450 m)、中度CHF组(150 m≤6MWD≤450 m)、重度CHF组(6MWD<150 m),每组各33例。应用二维斑点追踪技术获取右室整体纵向应变(RVGLS)及右室游离壁纵向应变(RVFWLS),4D Auto RVQ技术获取四维右室射血分数(4D-RVEF)、右室舒张末期容积指数(4D-RVEDVI)、四维右室收缩末期容积指数(4D-RVESVI)、四维右室每搏量指数(4D-RVSVI)、四维三尖瓣环收缩期位移(4D-TAPSE)、四维右室面积变化分数(4D-RVFAC),比较各组上述参数的差异。采用有序Logistic回归分析4D Atuo RVQ参数及应变参数与患者CHF程度的关系。结果轻度CHF组、中度CHF组及重度CHF组4D-RVEF、4D-RVSVI、4D-TAPSE、4D-RVFAC、RVGLS及RVFWLS均依次降低,组间两两比较差异均有统计学意义(均P<0.05)。重度CHF组4D-RVEDVI、4D-RVESVI均增大,与轻度CHF组和中度CHF组比较差异均有统计学意义(均P<0.05)。有序Logistic回归分析显示,4D-RVEF对患者CHF程度具有显著负向影响(β=-1.302,P<0.001)。结论4D Auto RVQ技术可以定量评价不同程度CHF患者右室功能,具有一定的临床应用价值。Objective To explore the clinical value of four-dimensional automatic right ventricular quantification(4D Auto RVQ)technology in assessing right ventricular function in patients with different degree of chronic heart failure(CHF).Methods A total of 99 patients with CHF from our inpatient department were prospectively selected,according to the sixminute walk distance(6MWD),the patients were divided into 3 groups:mild CHF group(6MWD>450 m),moderate CHF group(150 m≤6MWD≤450 m)and severe CHF group(6MWD<150 m),with 33 cases in each group.The right ventricular global longitudinal strain(RVGLS)and right ventricular free wall longitudinal strain(RVFWLS)were obtained by twodimensional speckle tracking imaging,and four-dimensional right ventricular ejection fraction(4D-RVEF),four-dimensional right ventricular end-diastolic volume index(4D-RVEDVI),four-dimensional right ventricular end-systolic volume index(4DRVESVI),four-dimensional right ventricular stroke volume index(4D-RVSVI),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 technology.The differences of the above parameters were compared in each group.Ordered Logistic regression analysis was used to analyze the correction of 4D Auto RVQ parameters,strain parameters and the degree of CHF.Results The 4D-RVEF,4D-RVSVI,4D-TAPSE,4D-RVFAC,RVGLS and RVFWLS in the mild CHF group,moderate CHF group and severe CHF group decreased in sequence,and the differences were statistically significant in pairwise comparsion(all P<0.05).Compared with the mild CHF group and the moderate CHF group,the 4D-RVEDVI and 4D-RVESVI in the severe CHF group were increased,and the differences were statistically significant(all P<0.05).Ordered Logistic regression analysis showed that 4D-RVEF had a significant negative impact on the degree of CHF in patients(β=-1.302,P<0.001).Conclusion 4D Auto RVQ technology can quantitatively evaluate the right ventricular function in patients w

关 键 词：超声心动描记术 四维自动右室定量技术 慢性心力衰竭 心室功能 右 

分 类 号：R540.45[医药卫生—心血管疾病]