三尖瓣环位移评价右室收缩功能的价值探讨

目的 探讨二维斑点追踪技术测定的三尖瓣环位移（TAD）评价右心室收缩功能的价值.方法 选择85例观察对象,其中RVEF＞50%的健康对照组40例,RVEF＜50%的右室收缩功能降低组45例.应用二维斑点追踪技术测定心尖四腔观三尖瓣环中点处（TADmid）的位移,实时三维超声心动图方法 获取右室射血分数（RVEF）,并分析TADmid与RVEF的相关性.结果 右室收缩功能降低组TADmid（8.01±3.93）mm]较健康对照组（13.75±3.26）mm]显著减低,差异有统计学意义（t=7.28,P＜0.01）.TADmid与RVEF呈正相关（r=0.76,P＜0.01）,TADmid评价RVEF＞50%的截断点为9.7,敏感性为72%,特异性为86%.结论 二维斑点技术测定的TAD与RVEF相关性良好,且操作简便易行,有望成为临床评价右室收缩功能的新指标.

Evaluation of right ventricular systolic function by tricuspid annular displacement

Objective To explore the value of tricuspid annular displacement (TAD) in evaluating right ventricular systolic function by speckle tracking imaging.Methods Forty healthy people (RVEF ＞50%) and forty five patients(RVEF ＜50%)were enrolled in this study.The apical four-chamber view was obtained and tricuspid annular midpoint displacement (TADmid) were measured by speckle tracking imaging.Right ventricular ejection fraction (RVEF) was measured by three-dimensional echocardiography.The correlation of tricuspid annular midpoint displacement (TADmid) and right ventricular ejection fraction (RVEF) was analyzed.Results These was statistical significance of tricuspid annular midpoint displacement between healthy people (RVEF ＞ 50%) and patients (RVEF ＜ 50%) (t = 7.28,P ＜ 0.01).There was positive correlation between TADmid and RVEF (P ＜ 0.01).The correlation coefficient between TADmid and RVEF was 0.76 (P ＜ 0.0l).The cut-off value of TADmid for RVEF ＞ 50% was 9.7 with a sensitivity of 72% and a specificity of 86%.Conclusions TAD by speckle tracking imaging showed an excellent correlation with RVEF.Tricuspid annular displacement by speckle tracking imaging was a simple and easy method,and it might be a new index in assessing right ventricular systolic function in clinical practice.