风湿性二尖瓣狭窄患者右室收缩功能的定量组织速度成像评价

目的定量组织速度成像评价风湿性二尖瓣狭窄(MS)合并三尖瓣返流(TR)患者右室收缩功能及其影响因素。方法选择58例MS合并TR患者和30例正常人进行研究,测量右室收缩横径(RVD),应用定量组织速度成像(QTVI)测量右心室游离壁基底段收缩期峰值速度(Vs)。MS患者测量三尖瓣返流速度,估测肺动脉收缩压(PASP);PASP轻度升高(30~50mmHg)的患者为A组,PASP中重度升高(>50mmHg)的患者为B组。测量三尖瓣反流面积(TRA)与右房面积(RAA),计算TRA/RAA比值反映三尖瓣反流程度。结果与对照组相比较,A组、B组Vs测值降低(P<0.05,P<0.01),RVD测值增大(P<0.01,P<0.01)。B组较A组Vs测值降低(P<0.05),RVD、TRA/RAA增大(P<0.01,P<0.01)。Vs与PASP、RVD、TRA/RAA均呈负相关(r=-0.30,P<0.05;r=-0.28,P<0.05;r=-0.42,P<0.01)。结论MS患者存在右室收缩功能降低,右室功能与肺动脉压、右室径、三尖瓣反流密切相关。

Assessment of Right Ventricular Function in Patients with Rheumatic Mitral Stenosis via Quantitative Tissue Velocity Imaging

Objective To investigate the right ventricular long-axis systolic function and its influencing factors in patients with rheumatic mitral stenosis(MS).Methods A total of 58 patients with MS and 30 healthy volunteers were involved in this study.All the patients have functional tricuspid regurgitation(TR).The end-systolic diameter(RVD) of the right ventricle was measured.The peak systolic velocity(Vs) of the basal segment of RV free wall was measured with quantitative tissue velocity imaging(QTVI) in 58 MS patients and 30 normal subjects.The presence and jet size of TR were evaluated and the pulmonary artery systolic pressure(PASP) was estimated from the peak velocity of the TR jet by color-Doppler in MS patients.Results The Vs was significantly decreased and RVD increased in MS patients than those in the normal subjects(P<0.05,P<0.01 respectively).There was negative correlation between Vs and PASP,RVD,the grade of TR(r=-0.30,P<0.05;r=-0.28,P<0.05;r=-0.42,P<0.01,respectively).Conclusions The right ventricular long-axis systolic dysfunction exists in MS patients.It has good relation with the PASP,RVD and TR.