左心房容积追踪技术评估缩窄性心包炎患者左心房容积和功能变化

目的 观察左心房容积追踪技术（LAVT）评估手术治疗前后缩窄性心包炎（CP）患者左心房容积和功能变化的临床价值。方法 对20例CP患者及20名健康志愿者（对照组），于心包切除术治疗CP术前（术前组）和术后（术后组）采集心尖四腔及两腔动态超声图像，以LAVT技术获得左心房容积参数，包括最大容积（LAV_max）、预收缩容积（LAV_pre）及最小容积（LAV_min），经体表面积校正得到容积指数（LAVI_max、LAVI_pre、LAVI_min）；以LAVT技术获得左心房容积变化速率参数，包括收缩期峰值充盈速率（dv/dtS）、舒张早期峰值排空速率（dv/dtE）及舒张晚期峰值排空速率（dv/dtA）。根据所得参数计算左心房总射血分数（LATEF）、被动射血分数（LAPEF）和主动射血分数（LAAEF），并进行分析。结果 3组LAV_min差异有统计学意义（P<0.05），术前组和术后组LAV_min均大于对照组（P均<0.05），术前组大于术后组（P<0.05）。3组LATEF、LAPEF、LAAEF、dv/dtS、dv/dtE和dv/dtA差异均有统计学意义（P均<0.05），术前组和术后组均小于对照组（P均<0.05），术前组小于术后组（P均<0.05）。结论 利用LAVT可评估心包切除术前后CP患者左心房容积和功能变化。

Left atrium volume tracking technique in assessing changes of left atrium volume and function in patients with constrictive pericarditis

Objective To explore the clinical value of left atrium volume tracking (LAVT) technique in assessment of left atrium (LA) volume and function changes in patients with constrictive pericarditis (CP). Methods Twenty CP patients who underwent pericardiectomy were enrolled. LA volume parameters, including LA maximum volume (LAV_max), pre-contraction volume (LAV_pre) and minimum volume (LAV_min) were obtained in CP patients before (preoperative group) and after pericardiectomy (postoperative group), also in 20 healthy subjects (control group) with LAVT technique. The measured volume parameters were calibrated with body surface area,and then LAVI_max, LAVI_pre, LAVI_min were obtained. Systolic filling rate of LA (dv/dtS), early diastolic emptying rate of LA (dv/dtE) and late diastolic emptying rate of LA (dv/dtA) were measured according to LA volume change velocity curve obtained with LAVT. Then LA total ejection fraction (LATEF), LA passive ejection fraction (LAPEF) and LA active ejection fraction (LAAEF) were also calculated. The parameters were compared among groups. Results Obvious differences of LAVI_min were found among 3 groups (P<0.05). LAVI_min in preoperative group and postoperative group were higher than that in control group (both P<0.05), while in preoperative group was higher than that in postoperative group (P<0.05). There were statistical differences of LATEF, LAPEF, LAAEF, dv/dtS, dv/dtE and dv/dtA among 3 groups (all P<0.05), those in preoperative group and postoperative group were lower than in control group (all P<0.05), in preoperative group were lower than in postoperative group (all P<0.05). Conclusion LAVT can be used to accurately assess changes of LA volume and function in CP patients before and after pericardiectomy.