三维斑点追踪超声心动图评价重度主动脉瓣狭窄患者经导管主动脉瓣置换术后的左室功能  

Evaluation of left ventricular function in patients with severe aortic stenosis after transcatheter aortic valve replacement by three-dimensional speckle tracking echocardiography

作　　者：王玲云[1] 韩正阳 赵娜[1] 王红鹄 王萌鹤 WANG Lingyun;HAN Zhengyang;ZHAO Na;WANG Honghu;WANG Menghe(Department of Ultrasound,the First Affiliated Hospital,Zhengzhou University,Zhengzhou 450052)

机构地区：[1]郑州大学第一附属医院超声医学科,郑州450052

出　　处：《郑州大学学报(医学版)》2025年第2期261-265,共5页Journal of Zhengzhou University(Medical Sciences)

基　　金：河南省医学科技攻关计划省部共建项目(SBGJ2018014)。

摘　　要：目的:探讨三维斑点追踪超声心动图(3D-STE)评价重度主动脉瓣狭窄(AS)患者经导管主动脉瓣置换术(TAVR)后左室功能的价值。方法:选取郑州大学第一附属医院收治的重度AS患者50例作为试验组,均接受TAVR手术,同时选择体检健康成年人50例作为对照组,测量对照组及试验组手术前和术后1个月的二维超声及3D-STE指标。二维超声测量指标包括左室舒张末期内径、左室收缩末期内径、室间隔厚度(IVST)、左室后壁厚度(LVPWT)、左室射血分数(LVEF)、左室流出道内径、主动脉瓣环直径、主动脉瓣口峰值流速(Vmax)、主动脉瓣口平均跨瓣压差(PGmean)、主动脉瓣口面积(AVA);3D-STE指标包括左室整体纵向应变(GLS)、左室整体环向应变(GCS)、左室整体径向应变(GRS)和左室整体面积应变(GAS)。结果:试验组术后Vmax和PGmean较术前减低,AVA较术前增加(P<0.05)。试验组术后IVST、LVPWT、Vmax和PGmean高于对照组,LVEF和AVA低于对照组(P<0.05)。试验组术后GLS、GCS、GRS和GAS的绝对值较术前增加,试验组术后GLS和GRS的绝对值低于对照组(P<0.05)。结论:3D-STE可有效评估重度AS患者TAVR术后左室收缩功能的改变。Aim:To explore the value of three-dimensional speckle tracking echocardiography(3D-STE)in evaluating left ventricular function in patients with severe aortic stenosis(AS)after transcatheter aortic valve replacement(TAVR).Methods:A total of 50 patients with severe AS admitted to the First Affiliated Hospital of Zhengzhou University were selected as the experimental group,all of whom underwent TAVR,and 50 healthy adults,as control group.The two-dimensional(2D)ultrasound and 3D-STE indexes were observed in the control group and in the experimental group(before and after TAVR).2D ultrasound indexes indicators included left ventricular end diastolic diameter,left ventricular end systolic diameter,interventricular septal thickness(IVST),left ventricular posterior wall thickness(LVPWT),left ventricular ejection fraction(LVEF),left ventricular outflow tract diameter,aortic annulus diameter,peak aortic valve velocity(Vmax),mean transvalvular pressure gradient(PGmean),and aortic valve area(AVA).The 3D-STE indexes included global longitudinal strain(GLS),global circumferential strain(GCS),global radial strain(GRS)and global area strain(GAS)of the left ventricle.Results:The postoperative Vmax and PGmean in the experimental group decreased compared with preoperative levels,while AVA increased(P<0.05).The postoperative IVST,LVPWT,Vmax,and PGmean of the experimental group were higher than those of control group,while LVEF and AVA were lower(P<0.05).The absolute values of GLS,GCS,GRS,and GAS in the experimental group increased after surgery compared to before surgery(P<0.05).The absolute values of GLS and GRS in the experimental group after surgery were lower than those in control group(P<0.05).Conclusion:3D-STE could effectively evaluate changes in left ventricular function of severe AS patients after TAVR.

关 键 词：三维斑点追踪超声心动图 经导管主动脉瓣置换术 主动脉瓣狭窄 左室功能 

分 类 号：R542.5[医药卫生—心血管疾病]