实时三维经食管超声心动图定量分析正常二尖瓣立体结构动态的变化

目的 探讨实时三维经食管超声心动图(RT-3DTEE)分析正常二尖瓣几何构型随时间的演变规律。方法 选取二尖瓣形态和功能正常者33例,采用RT-3DTEE定量二尖瓣参数,并应用二尖瓣定量分析软件进行数据分析。结果 心动周期中,前叶瓣环中点至后叶瓣环中点的距离(DAP)在舒张早期最大,逐渐减小,至收缩早期最小;二尖瓣环曲率(H/DAIPm)舒张早期最小,逐渐增大,至收缩早期最大;主动脉瓣环与二尖瓣环平面的夹角(θ)收缩早期最大;前叶与瓣环的夹角(θAnt)与后叶与瓣环的夹角(θPost)在整个心动周期中变化趋势相一致;前叶与后叶的夹角(θNPA)舒张中期降至最小,后又逐渐上升,收缩晚期达最大。结论 RT-3DTEE技术可获得正常二尖瓣的测量参数及其随时间动态变化的演变规律,可为二尖瓣疾病的诊断及治疗提供一定的客观依据。

Real-time three-dimensional transesophageal echocardiography quantitative assessment of dynamic variation of mitral valve geometry

Objective To analyze the dynamic variation of normal mitral valve geometry with real-time three-dimensional transesphageal echocardiography (RT-3DTEE). Methods Thirty-three patients with normal mitral valves shape and function were enrolled. The mitral valves parameters were quantitated by RT-3DTEE and analyzed by mitral valve quantification. Results During the cardiac cycle, the anterior to posterior diameter of annulus (DAP) reached peak at early diastole, then gradually decreased, and dropped to the minimum at early systole. The ratio of annular height to intercommissural diameter (H/DAIPm) reached the minimum at early diastole, then gradually increased, and reached to peak at early systole. Aortic orifice to mitral plane angle (θ) reached to peak at early systole. The change trend of the angle of anterior leaflet (θAnt) and angle of posterior leaflet (θPost) was consistent throughout the cardiac cycle. The non-planar angle of leaflets (θNPA) reached minimum at middle diastole, then gradually increased, and increased maximam at late systole. Conclusion Dynamic variation of mitral valve geometry can be assessed quantitatively by RT-3DTEE, and can provide evidence for the diagnosis and treatment of mitral valve disease.