三维超声测量左心房容积及其对左室舒张功能的评价

摘要

目的 利用三维超声心动图测量左心房容积,探讨三维测量的左心房参数与左室舒张功能分级的关系以及与E/E'的相关性.方法 全部390例,分为正常组(300例)及左室驰张功能异常组、假性正常化组和限制性充盈组(各30例),三维超声心动图测量和计算左心房容积(LAV)、左心房容积指数(LAI)、左心房排空率(LAEV),E/E'是多普勒超声二尖瓣口舒张早期E峰与多普勒组织成像侧壁二尖瓣环舒张早期频谱E'之比.结果 (1)正常人群组三维超声心动图左心房参数LAV 15.1～47.6 ml,平均(27.1±7.3)ml;LAI 10.7～28.5 ml/m2,平均(16.3±4.2)ml/m2;LAVE 55%～74%,平均(66.1±4.0)%.(2)随左室舒张功能分级的增加,LAV、LAI数值增加,LAEV减小,LAI与左室舒张功能的分级呈现良好的相关性.(3)LAI与E/E'显示良好的相关性.结论 三维超声测量的左心房参数评价左室舒张功能意义较大,优于传统超声心动图的常规左房参数;评价左室舒张功能,LAI与E/E'呈现良好的相关性.%Objective To assess left ventricular (LV) diastolic function using left atrial volumetric parameters by three dimentional echocardiography.Methods Three hundred and ninety patients were divided into four groups: the normal, the impaired relaxation, the pseudonormal and the restrictive filling groups.All patients underwent three dimensional echocardio graphy to calculate the LA volume, left atrial volume index (LAI) and left atrial emptying volume (LAEV).The early peak of diastolic flow velocity of the mitral flow (E) were detected by Doppler echocardiography and early peak of diastolic velocity of mitral annular velocity (E') were measured by Tissue Doppler Imaging.Results In normal subjects, the LA volume, LAI and LAEV were 27.1±7.3 ml, 16.3±4.2 ml/m2 and 66.1±4.0％, respectively.There were increasing in LA volume and LAI,and decreasing in LAEV with increasing in the grading of the LV diastolic function.The LAI was related well to the LV diastolic function and well correlated to E/E'.Conclusions The volumetric indices of LA by three dimensional echocardiographic may be valuable in assessing left ventricular diastolic function.