定量组织速度成像对房间隔缺损患者右室功能的评价

目的应用定量组织速度成像(QTVI)评价房间隔缺损(ASD)患者右室壁整体及局部舒缩功能,为临床提供一种准确、快速、无创地评价右室壁舒缩功能的方法。方法应用QTVI获取30例肺动脉压力正常或轻度增高的ASD患者和30例正常对照组右心室心肌四个位点的组织运动速度曲线,对照组根据右室游离壁三尖瓣环位点QTVI舒张早期与心房收缩期峰值运动速度(Ve、Va)比值,分为A组(Ve/Va﹥1,11～40岁)及B组(Ve/Va﹤1,43～64岁);ASD组按年龄、例数匹配也分为A、B两组。比较并分析ASD组与对照组间收缩期峰值运动速度(Vs)、舒张早期及心房收缩期峰值运动速度(Ve、Va)及Ve/Va比值。结果与对照组A组比较,ASD患者A组右室游离壁三尖瓣环及中部位点Vs显著增加(P<0.001),两个位点的Ve、Va及Ve/Va无显著变化;室间隔三尖瓣环及中部位点Vs、Ve、Va及Ve/Va均未见显著变化;与对照组B组比较,ASD患者B组右室游离壁三尖瓣环及中部位点Vs、室间隔三尖瓣环及中部位点的Vs显著增加(P<0.001),右室游离壁三尖瓣环及中部位点Ve增加(P<0.05),Va显著增加(P<0.001),但Ve/Va无显著变化;室间隔三尖瓣环及中部位点Ve、Va及Ve/Va均未见显著变化。结论 QTVI可以定量检测ASD患者随病程进展右室游离壁及室间隔整体及局部的舒缩功能的变化,为临床早期评价ASD右室舒缩功能提供信息。

Assessment of Right Ventricular Function in Patients with Atrial Septal Defect Using Quantitative Tissue Velocity Imaging

Objective To assess the right ventricular myocardium in patients with atrial septal defect(ASD) using quantitative tissue velocity imaging(QTVI).Methods velocity of systole(Vs),early diastole velocity(Ve),atrial systole velocity(Va)and calculate the rate of Ve /V in 30 ASD patients with Pulmonary artery pressure normal or mild pulmonary hypertension and 30 normal subjects were measured by QTVI.Control group were divided into Group A(Ve/Va﹥1,11～40 years old) and Group B(Ve /Va<1,43～64 years old).ASD group were divided into Group A and Group B based on age.systole velocity(Vs)peak,early diastole(Ve) peak,atrial systole(Va)peak and Ve/Va ratio of right ventricular myocardium between the ASD group and the control group were compared and analyzed.Results In the early course of disease,Compared with control group,Vs of ASD group tricuspid annular and the centre of right ventricular free wall significantly increased(P<0.001),Ve,Va and Ve/Va of ASD group tricuspid annular and the centre of right ventricular free wall did not significantly change;Vs,Ve,Va and Ve/Va of ASD group tricuspid annular and central of interventricular septum all did not significantly change.With the progress of the disease,Compared with control group :Vs of ASD group tricuspid annular and the central of interventricular septum also significantly increased(P<0.001);Ve of ASD group tricuspid annular and the centre of right ventricular free wall significantly increased(P<0.05),Va of ASD group tricuspid annular and the centre of right ventricular free wall significantly increased(P<0.001),but There was no significant change in Ve and Va ratio;Ve,Va and Ve/Va of ASD group tricuspid annular and central of interventricular septum all did not significantly change.Conclusion QTVI technology may measure right ventricular free wall and interventricular septum integral and regional systolic and diastolic function in patients with ASD during the disease course.