实时三维超声心动图对健康人右心功能的初步探讨

摘要

ObjectiveTo validate the feasibility and accuracy of right ventricular (RV) volume and systolic function with single cardiac cycle real-time three-dimensional (3D) echocardiography. MethodsThree-dimensional images of RV and left ventricle (LV) were obtained in 122 healthy adults by 3D matrix array transducer. The end systolic volume (ESV), end diastolic volume (EDV), stroke volume (SV) and ejection fraction (EF) were measured by RV analysis and LV analysis software. To validate the reliability of measurement of right ventricle by real-time three-dimensional echocardiography, the correlations of RV functional parameters and multiple parameters (such as age, gender and body surface area) were analyzed. And the correlation and difference between different modalities of left ventricle and right ventricle were compared.Results3D-RVEF was (55.66±13.97)%, 3D-RVEDV was (68.24±40.19) ml, 3D-RVESV was (30.09±19.14) ml and 3D-RVSV was (38.30±26.10) mL. RVSV and RVEF of normal men were larger than those of normal women, but no statistical difference were found [(40.15±26.15) mlvs (36.11±25.60) ml, (55.69±14.57)%vs (55.62±13.36)%, bothP>0.05]. RV related function parameters had no relevant correlation with age (P>0.05). Body surface area was weakly related to RVEDV, RVESV and RVSV (r=0.236, 0.247 and 0.178, allP<0.05). BSA had no correlation with RVEF. 3D-RVSV and 3D-RVEDV were weakly positively correlated with 3D-LVSV and 3D-LVEDV (r=0.215 and 0.201, bothP<0.05). 3D-RVEF and 3D-RVESV were not correlate with 3D-LVEF and 3D-LVESV.ConclusionThe single cardiac cycle real-time three-dimensional echocardiography is a simple and feasible method for assessment of right ventricular function and can quantify right ventricular contractive function precisely.%目的：探讨单心动周期实时三维超声心动图测量健康人右心室容积及收缩功能的可行性及准确性。方法应用三维矩阵探头采集122名健康成人的右心室、左心室三维图像，使用RV Analysis及LV Analysis软件分别检测左、右心室收缩功能参数，包括收缩末期容积（ESV）、舒张末期容积（EDV）、每搏心输出量（SV）及射血分数（EF），将多种参数（性别、年龄、体表面积）分别与右心室功能参数进行相关分析，同时将左心室及右心室各参数进行比较及相关分析，验证实时三维超声心动图测量右心室功能的可靠性。结果健康人三维右心室EF为（55.66±13.97）%，EDV为（68.24±40.19）ml，ESV为（30.09±19.14）ml，SV为（38.30±26.10）ml；男性受试者右心室SV、EF高于女性，但无统计学差异[（40.15±26.15） mlvs（36.11±25.60） ml，（55.69±14.57）%vs （55.62±13.36）%，P均＞0.05]；右心室的相关功能参数与受试者年龄无相关性（P＞0.05）；体表面积（BSA）与右室EDV、ESV及SV呈弱相关性（r=0.236、0.247、0.178，P均＜0.05），但与右心室EF无相关性（P＞0.05）。左心室SV与右心室SV及左心室EDV与右心室EDV之间存在弱正相关关系（r=0.201、0.215，P均＜0.05）。双室的EF之间及ESV之间无相关性（P＞0.05)。结论单心动周期实时三维超声心动图技术是一种简单易行的评价右心功能的方法，能较准确地评估右心室的收缩功能。