三尖瓣环运动对慢性心力衰竭患者右室功能的评价

目的:应用组织速度显像(Tissue velocity imaging,TVI)研究三尖瓣环运动对慢性心力衰竭患者有室功能评价的价值.方法:我院诊断为NYHA心功能1-3级、LVEF≤45%(Simpson法)的慢性心力衰竭患者19例为心衰组,设年龄相当的正常人14例为对照组.于心尖四腔观三尖瓣环近右室游离壁水平获取该瓣环的TVI曲线,分别测量其射血期、快速充盈期、心房收缩期瓣环沿长轴方向运动的平均峰值速度(VS、VE、VA)以及等容收缩期、射血期、等容舒张期各时相的持续时间(IVS、S、IVR).结果:心衰组三尖辩环近右室游离壁处VS和VE均显著低于正常组,而VA、VE/VA、IVC、S、IVR与正常对照组比较差别无统计学意义.结论:以TVI分析三尖瓣环运动参数尤其射血期平均峰值速度VS和快速充盈期平均峰值速度VE可敏感评估慢性心衰患者右室舒缩功能.

Evaluation of right ventricular function in patients with chronic heart failure by analyzing tricuspid annular motion

Objective: To evaluate right ventricular function in patients with chronic heart failure by applying tissue velocity imaging. Methods: Nineteen patients who were diagnosed as chronic heart failure with NYHA grade1～3 and LVEF≤45%(Simpson method)were enrolled as heart failure group.Fourteen healthy subjects who were age-matched were taken as control group. After the tissue velocity imaging curve of tricuspid ring on level of right ventricular free wall from apical four chamber view was got, the following parameters were measured: mean peak velocities velocity of ejection phase (V_s), velocity of rapid filling phase (V_E) and velocity of atrial systole period (V_A)] of the longitudinal motion , duration of different phases isovolumetric contraction phase(IVC), ejection phase (S) and isovolumic relaxation phase (IVR)]. Results: Compared with control group, V_s and V_E of tricuspid ring on level of right ventricular free wall were reduced in heart failure group, whereas V_A, IVC, V_E/V_A, S and IVR were not significantly different. Conclusion: Analyzing tricuspid annular motion , especially V_s and V_E by applying TVI is sensitive to the evaluation of right ventricular function in patients with heart failure.