实时三维超声心动图对正常二尖瓣与功能性反流二尖瓣闭合线的对比研究

目的 应用实时三维超声心动图对正常人和功能性反流者的二尖瓣闭合线形态进行对比,探讨功能性反流状态下二尖瓣闭合线形态的变化规律.方法 二维超声筛选功能性二尖瓣反流的成年患者20例,随后进行实时三维超声心动图检查,采集二尖瓣数据导入TomTec三维工作站进行脱机分析;并与20例正常人二尖瓣闭合线数据进行对照,对照指标包括：闭合线两端点之间的直线距离,投影平面上的闭合线曲线长度,闭合线高度（h）,α和β角,并计算｜α-β｜.结果 显著功能性二尖瓣反流的闭合线形态不规则且不对称,与正常人比较,功能性反流二尖瓣闭合线直线距离、α角、β角测值差异均有统计学意义（P〈0.05）,曲线长度、高度（h）及计算所得的｜α-β｜值差异均有统计学意义（P〈0.01）.结论 显著功能性反流二尖瓣闭合线相对正常状态下有显著差异,这种改变与功能性反流时瓣环形状改变和瓣下牵拉状态异常有关.

Comparative study of mitral valve closure line between normal state and functional mitral regurgitation by real-time three-dimensional echocardiography

Objective To compare the mitral valve closure line between normal state and functional mitral regurgitation by real- time three- dimensional echocardiography （RT- 3DE）, and to investigate the diversification discipline of mitral valve closure line configuration in functional mitral regurgitation. Methods Twenty adult patients with functional mitral regurgitation were selected by two -dimensional ultrasound, then full- volume images of mitral valve were examined by RT -3DE, and the results were input in TomTec workstation and analyzed offline. The data were compared with those from 20 normal human. The comparative parameters including straight length between sides point, curve distance in the projected plane, height （h）, et and β angle, the ｜α - β ｜ were calculated. Results The mitral valve closure line configuration of functional mitral regurgitation was irregular and asymmetrical. Compared with normal subjects, there was significant difference of mitral valve closure line straight length, α and β angle between two groups （P 〈 0.05）, and there was significant difference of curve length, the height （h） and ｜α - β ｜ （P 〈 0.01 ）. Conclusion There is significant difference in mitral valve closure line configuration between normal and patients with functional mitral regurgitation. And the change is related to the variation of annulus shape and tensile condition below mitral valve.