实时三维超声心动图评价右室收缩功能的初步临床研究

目的 应用实时三维超声心动图(RT-3DE)检测右室收缩功能,并与传统二维超声心动图对照,探讨该技术的可行性与准确性。方法 使用RT-3DE系统采集32例健康志愿者的右室“金字塔”型数据库,结合容积分析软件,采用心尖八平面法勾勒右室舒张末期容积(RVEDV)和收缩末期容积(RVESV),并计算右室每搏量(RVsV)和射血分数(RVEF);同时在M型超声心动图上测量右室游离壁三尖瓣环处的收缩期位移(TASE)、二维超声心动图上勾画右室面积变化分数(FAC),比较三维容积法测定的收缩指数与TASE、FAC间的相关性。结果 RT-3DE测量的RVSV、RVEF均与TASE呈显著正相关(r=0．90;r=0．83);RVEF与FAC之问呈正相关(r=0．63)。结论 实时三维超声容积成像能快速简便、准确无创地确定右室容积,为临床早期评估右心收缩功能提供了有力手段,具有极其广阔的发展前景。

Clinical Study on the Evaluation of Right Ventricular Systolic Function by Real-Time Three-Dimensional Echocardiography

Objective Aim of this study was to evaluate right ventricular systolic function using indices derived from real-time three-dimensional echocardiography (RT-3DE), and to determine its clinical value. Methods Right ventricular "Full Volume" imaging was acquired by RT-3DE; Right ventricular end-diastolic volume (RVEDV) and right ventricular end-systolic volume (RVESV) were outlined using apical 8-plane method by the analysis software of RT-3DE offline. RVSV and RVEF were calculated RVSV=RVEDV-RVESV; RVEF=(RVEDV-RVESV)/RVEDV]. Meanwhile tricuspid annual systolic excursion (TASE) was measured by M-mode echocardiography; right ventricular fraction area change (FAC) was outlined by two-dimensional echocardiography. Results There were strong positive correlation of TASE to RVSV and to RVEF derived from RT-3DE ( r =0.83; r =0.90). There was positive correlation between RVEF and FAC ( r =0.63). Conclusion Real-time three-dimensional echocardiography could be used to rapidly, accurately, noninvasively determine right ventricular volume, RVSV and RVEF. It may allow early detection RV systolic function in clinical settings.