斑点追踪显像测量三尖瓣环位移评估右室收缩功能

摘要

目的:探讨二维超声斑点追踪显像(STI)测量三尖瓣环位移(TAD)在评价右室收缩功能中的临床应用价值.方法:研究对象为30例正常人和32例右心功能不全患者,应用内置QLAB 6.0分析软件,分别于心尖四腔观、心尖右室两腔观系统自动测算三尖瓣环右室游离壁收缩期峰值(TADfre)和室间隔收缩期峰值(TADsep)、三尖瓣环前壁收缩期峰值(TADant)和后壁收缩期峰值(TADpos)及右心室长轴缩短率(RVLFS).用双平面Simpson法测量右室射血分数(RVEF).结果:患者组TAD各测值以及RVLFS均显著低于对照组(P<0.01);患者组TADfre、TADant、TADpos及RVLFS与RVEF呈显著正相关(均P<0.05).相关系数分别为0.707、0.752、0.738、0.872.TADsep与RVEF相关性不显著(P>0.05,r=0.562).结论:二维超声斑点追踪显像测量TADfre、TADant、TADpos及RVLFS能快速、准确、无创的评估右室收缩功能,有望成为临床评价右室收缩功能的新方法.%Objective:To explore the peak systolic displacement of tricuspid annulus (TAD) in evaluation of right ventricular systolic function by speckle tracking imaging (STI). Methods:The subjects included 32 patients with right heart failure and 30 hearthy adults. The peak systolic displacements of tricuspid annulus at right ventricular free (TADfre) · septum (TADsep). anterior (TADant), posterior (TADpos) walls and the right ventricular longitudinal fractional shortening (RVLFS) were acquired at the apical four-chamber view and the apical right ventricular two-chamber view by using QLAB 6.0 software. The right ventricular ejection fraction (RVEF) was measured with Simpson method. Results: Compared with control group, the parameters of TAD and RVLFS in right heart failure group were significantly lower ( P ＜0. 01). The correlation between RVEF and TADfre. TADant. TADpos ( r =0. 707. 0. 752. 0. 738. respectively. all P ＜0. 05) were significant, but TADsep showed not correlation with RVEF in right heart failure group( r = 0.562, P ＞0.05). Conclusion: TADfre. TADant, TADpos and RVLFS, based on two-dimensional speckle tracking imaging, were proved to be rapid, non-invasive and accuracy in evaluating right ventricular systolic function and it may be a new promising method.