实时三维超声心动图评价房间隔缺损右心室整体及节段收缩功能

目的探讨实时三维超声心动图(real-time three-dimensional echocardiography,RT-3DE)评价房间隔缺损患者右心室整体及节段收缩功能的可行性及准确性。方法使用RT-3DE采集27例房间隔缺损(atrial septal defect,ASD)患者和32例健康志愿者心脏全容积图像,应用Tomtec公司的Manual4D RV-Function CAP分析软件测量右心室整体及3节段收缩功能,得到右心室整体和节段舒张末期容积、收缩末期容积,射血分数,并通过软件自动生成右室节段容积-时间变化曲线。结果RT-3DE可以同步评价右心室整体及节段收缩功能。ASD患者的右室收缩功能下降(P=0.017),3节段中流出道部和小梁部的收缩功能下降最为明显(P=0.036,0.008),流入道部收缩功能下降无统计学意义(P=0.554)。结论RT-3DE可有效评价右室整体及节段收缩功能,对于房间隔缺损患者的手术治疗及预后评价有重要意义。

Evaluation of Global and Regional Right Ventricular Systolic Function in Patients with Atrial Septal Defect Using Real-time Three-dimensional Echocardiography

Objective To demonstrate whether the real-time three-dimensional echocardiography(RT-3DE)can be used to assess right ventricular(RV)global and regional systolic function in patients with atrial septal defect(ASD).Methods Twenty-seven patients with ASD and thirty-two normal controls were studied.Full volume images were obtained on RT-3DE in all the subjects,then 3-segmental volume-time curves of RV were obtained by analysis software(Tomtec Manual 4D RV-Function CAP).The end-diastolic volume,end-systolic volume,ejection fraction of the right ventricle and the regional volume and ejection fraction of the 3 segments were acquired.Results The RT-3DE imaging method provided simultaneous quantification of the global and regional RV function.Global RV systolic function was decreased in ASD patients(P=0.017),the outflow and the body segment of RV were decreased significantly in the patient group(P=0.036,0.008 respectively),the inflow segment was mildly decreased(P=0.554).Conclusions The RT-3DE is an new technology in the evaluation of global and regional right ventricular systolic function.It can help the surgeon to choose an optimal method and to evaluate patients prognosis more precisely.