实时三维超声心动图评估射血分数减低的左心力衰竭患者的右心室重构

发布时间：2018-03-11 12:25

本文选题：心力衰竭　切入点：肺高压　出处：《中国医学影像技术》2016年05期 　论文类型：期刊论文

【摘要】：目的采用单心动周期实时三维超声心动图(sRT-3DE)结合传统二维超声心动图探讨左心室射血分数(LVEF)减低的左心力衰竭患者肺高压(PH)对右心室重构的影响。方法对sRT-3DE检查LVEF50%的60例患者(病例组)根据肺动脉收缩压(PASP)及肺血管阻力(PVR)不同分为3个亚组:HF-NPH亚组15例,HF-PPH亚组15例,HF-RPH亚组30例,正常健康人35名为对照组。对两组行常规二维超声及sRT-3DE检查,分析获得三维、二维及多普勒超声参数,进行组间对比分析和相关性分析。结果与对照组比较:病例组右心室舒张末期容积指数(EDVI)、收缩末期容积指数(ESVI)、基底部横径(D1)、长径(LD)、D1/中间横部径(D2)、射血分数(EF)减小。与HF-NPH亚组比较,HF-PPH亚组右心室ESVI、D1/D2、LD/D2增大。与HF-PPH亚组比较,HF-RPH亚组右心室EDVI、ESVI、D2增大,右心室EF、LD/D2减低。PVR与PASP、右心室EF与左心室EF、右心室LD与左心室LD呈正相关性(r=0.765、0.628、0.725;P均0.01),PVR与右心室EF呈负相关(r=-0.715,P0.01),且高于与PASP的相关性(r=-0.623,P0.01)。结论 sRT-3DE结合传统二维及多普勒超声可准确评估左心力衰竭患者的右心室重构,有助于判断右心室结构和功能状态。
[Abstract]:Objective to investigate the effect of left ventricular ejection fraction (LVEF) on right ventricular remodeling in patients with left heart failure by single cycle real-time three-dimensional echocardiography (RT-3DED) combined with traditional two-dimensional echocardiography. Methods sRT-3DE was performed in patients with left heart failure. According to pulmonary arterial systolic pressure (PASP) and pulmonary vascular resistance (PVR), 60 patients (LVEF 50%) were divided into 3 subgroups: 15 cases of HF-PPH subgroup, 15 cases of HF-PPH subgroup, 30 cases of HF-RPH subgroup. 35 healthy persons were used as control group. The parameters of three-dimensional, two-dimensional and Doppler ultrasound were obtained by routine two-dimensional ultrasound and sRT-3DE examination in both groups. Results compared with the control group, the right ventricular end-diastolic volume index (EDVI), the end-systolic volume index (ESVI), the basal transverse diameter (D _ 1), the long diameter (D _ (1)), the middle transverse diameter (D _ (2)) and the ejection fraction (EF) were decreased in the case group. Compared with the HF-NPH subgroup, the right ventricular ESVII D 1 / D 2 D 2 increased in the HF-PPH subgroup, and the right ventricular EDV I I D 2 increased in the HF-RPH subgroup compared with the HF-PPH subgroup. LDR / D2 of right ventricle decreased. PVR and PASP, EF of right ventricle and EFF of left ventricle, LD of right ventricle were positively correlated with LD of left ventricle. Sound can accurately evaluate the right ventricular remodeling in patients with left heart failure. It is helpful to judge the structure and function of right ventricle.
【作者单位】：中国医科大学附属第一医院心血管超声科;
【基金】：高等学校博士学科点专项基金(20112104110010) 沈阳市科技攻关项目(F12-193-9-19)
【分类号】：R540.45;R541.6

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