摘要
目的:旨在应用二维斑点追踪成像技术(2D-STI)评估法洛四联症矫治术后(rTOF)中远期合并重度肺动脉瓣反流患者左心室整体及局部收缩功能。方法:将74例合并重度肺动脉瓣反流的rTOF患者作为病例组,将70例健康人作为正常对照组,应用超声心动图获取心脏结构及功能参数;应用2D-STI获取左心室收缩功能应变参数,比较病例组与对照组间上述参数的差异。结果:(1)两组左室射血分数(LVEF)均正常,组间比较无统计学差异(P=0.177);病例组左室舒张末期内径指数(LVEDDI)、左室舒张末期容积指数(LVEDVI)及室间隔侧二尖瓣前瓣环舒张早期运动速度(e’)显著低于对照组(P<0.005);右室舒张末期内径指数(RVEDDI)、肺动脉前向血流峰值速度(PV)显著高于对照组(P<0.001),二尖瓣口舒张早期血流峰值速度(E)、E/e’比值高于对照组(P<0.05)。(2)病例组左心室整体、3个切面、6个室壁收缩期峰值纵向应(LS)及左心室基底段、中间段、心尖段收缩期峰值圆周应变(CS)均较对照组减低(P<0.005),其中以前间隔LS减低最为明显,且CS由基底段向心尖段递增规律消失。结论:(1)rTOF中远期合并重度肺动脉瓣反流患者仍受异常血流动力学影响,左、右心室存在不同程度的不良重构。(2)rTOF中远期合并重度肺动脉瓣反流患者左心室整体及局部收缩功能已出现亚临床损伤,2D-STI可敏感地识别亚临床心肌受损。
Objective:To assess the global and regional systolic function of left ventricle by two-dimensional speckle tracking imaging(2D-STI)in patients with severe pulmonary regurgitation of repair of tetralogy of Fallot(rTOF).Methods:Seventy-four rTOF patients with severe pulmonary regurgitation were treated as case group,and 70 healthy people as normal control group.Cardiac structure and function parameters were obtained by echocardiography.The strain parameters of left ventricular systolic function were obtained by 2D-STI.The differences of the above parameters between the two groups were compared.Results:(1)Left ventricular ejection fraction(LVEF)was normal in both groups,and there was no significant difference between the two groups(P=0.177).The left ventricular end diastolic diameter index(LVEDDI),left ventricular end diastolic volume index(LVEDVI)and the early diastolic mitral annulus velocity(e’)at the interventricular septum in the case group were significantly lower than those in the control group(P<0.005).The right ventricular end diastolic diameter index(RVEDDI)and pulmonary velocity(PV)in the case group were significantly higher than those in the control group(P<0.001),and the peak flow velocity(E)and E/e’ratio at the early diastolic stage of the mitral valve were higher than those in the control group(P<0.05).(2)The longitudinal peak systolic strain(LS)of the whole left ventricle,3 sections,6 ventricular walls and the peak systolic circumferential strain(CS)of the basal,middle and apical segments of the left ventricle in the case group were lower than those in the control group(P<0.005).Conclusion:(1)Patients with middle and long-term rTOF combined with severe pulmonary regurgitation are still affected by abnormal hemodynamics,left and right ventricle have different degrees of adverse remodeling.(2)In patients with middle and long-term rTOF combined with severe pulmonary regurgitation,the global and local systolic function of left ventricle has been subclinically impaired.2D-STI can sensitively identify subclinical myocardial damage.
作者
谢佳
唐红
张晓玲
周雅馨
徐婷
边叶婷
XIE Jia;TANG Hong;ZHANG Xiao-ling;ZHOU Ya-xin;XU Ting;BIAN Ye-ting(Department of Cardiology,Building Hospital,Sichuan Province,Chengdu 610084,China;West China Hospital,Sichuan University,Chengdu 610041,China)
出处
《中国临床医学影像杂志》
CAS
CSCD
2023年第1期28-32,共5页
Journal of China Clinic Medical Imaging
关键词
法洛四联症
肺动脉瓣闭锁不全
心室功能
左
超声心动描记术
Tetralogy of Fallot
Pulmonary Valve Insufficiency
Ventricular Function
Left
Echocardiography
