组织多普勒成像评价ASD封堵术后右心室长轴收缩功能的变化

目的探讨房间隔缺损(ASD)封堵术后右心室长轴收缩功能变化及其临床价值。方法对行ASD封堵术的34例患者应用组织多普勒成像(TDI),测定在封堵术前、术后1周和3个月的右心室侧壁处三尖瓣环收缩期峰值运动速度(SM)、位移(DS)、收缩前期时间(PCTM)、收缩时间(CTM)及PCTM/CTM。结果ASD患者封堵术后1周,SM(14.80±2.50)cm/s、DS(2.34±0.30)cm较术前SM(17.90±3.30)cm/s、DS(2.67±0.36)cm,显著减少(t=2.20、4.12均P<0.05);CTM(280.00±22.00)ms及PCTM/CTM0.32±0.13较术前CTM(261.00±23.00)ms及PCTM/CTM(0.29±0.08)显著增加(t=3.48、2.25,均P<0.05);术后3月SM(14.10±2.40)cm/s、DS(2.17±0.23)cm较术后1周进一步减小(t=2.18、2.62,均P<0.05)。结论封堵术后ASD患者右心室长轴收缩功能改善,TDI为评价ASD患者右心室功能提供了一个无创、简便和准确的新途径。

Assessment of right ventricular long-axis systolic function in patients with transcatheter closure of atrial septal defect using tissue doppler imaging

Objective To assess the change of the right ventricular long-axis systolic function before and after transcatheter closure of atrial septal defect(ASD).Methods Using tissue Doppler imaging(TDI),the lateral tricuspid annular systolic peak velocity(SM),the systolic excursion(DS),the pre-contraction time(PCTM),contraction time(CTM)and PCTM/CTM ratio of right ventricle were measured in 34 patients with ASD before and 1 week,3 months after transcatheter closure of ASD.Results SM,DS were significantly decreased after transcatheter closure(P<0.05),CTM and PCTM/CTM rafio were increased significantly(P<0.05),SM,DS further decreased 3 months after transcatheter closure(P<0.05).Conclusion After transcatheter closure,right ventricular long-axis function significantly improved.TDI provides a new non-invasive,simple and reliable approach for assessment of right ventricular function in patients with ASD.