组织二尖瓣环位移技术评价重度子痫前期病人左心房功能的应用价值

目的应用组织二尖瓣环位移(TMAD)技术评价重度子痫前期(SPE)病人左心房功能,探讨其临床应用价值。方法选取SPE病人46例(SPE组)和正常妊娠(NP)孕妇43名(NP组),分别行常规及全容积超声心动图检查。采用全容积成像技术获取标化左房膨胀指数(LAEI)、左房被动排空分数(LAPEF)和左房主动排空分数(LAAEF);采用TMAD技术获取相应参数:左心房充盈期位移(TMAD-D)、被动射血期位移(TMAD-P)及左心房收缩期位移(TMAD-S)。结果与NP组相比,SPE组TMAD-D、TMAD-P和TMAD-S降低,差异均有统计学意义(P<0.001);与NP组相比,SPE组标化LAEI、LAPEF和LAAEF均降低,差异均有统计学意义(P<0.001);SPE组TMAD-D、TMAD-P和TMAD-S与相应的标化LAEI、LAPEF、LAAEF均呈正相关(r值分别为0.645、0.576、0.572,P<0.001);TMAD-D、TMAD-P和TMAD-S诊断左房功能受损的曲线下面积(AUC)分别为0.868、0.832、0.759;标化LAEI、LAPEF、LAAEF的AUC分别为0.880、0.840、0.835;全容积成像参数的AUC较TMAD相应参数的AUC略增大,但差异均无统计学意义(P>0.05)。结论TMAD技术可简便、快速、准确地评价SPE病人左房时相功能,可作为临床评价左房功能的新方法。

Clinical Value of Tissue Mitral Annular Displacement Technique in Evaluating Left Atrial Function in Patients withSevere Preeclampsia

Objective To evaluate clinical value of tissue mitral annular displacement(TMAD)technique in evaluating left atrial function in patients with severe preeclampsia(SPE).Methods Forty-six SPE patients(SPE group)and 43 normal pregnant women(NP group)were selected,while routine and full-volume echocardiography were performed respectively.The indexed left atrial expansion index(LAEI),left atrial passive emptying fraction(LAPEF)and left atrial active emptying fraction(LAAEF)were determined by full-volume imaging technology.The corresponding parameters including left atrial filling period displacement(TMAD-D),passive ejection period displacement(TMAD-P)and atrial systolic period displacement(TMAD-S)were obtained by TMAD technology.Results Compared with NP group,TMAD-D,TMAD-P,TMAD-S,LAPEF and LAAEF in SPE group decreased(P<0.001).TMAD-D,TMAD-P and TMAD-S in SPE group were positively correlated with corresponding standardized parameters including LAEI,LAPEF and LAAEF(r=0.645,0.576,0.572,P<0.001).The area under the curves(AUC)of TMAD-D,TMAD-P and TMAD-S in diagnosing left atrial function impairment were 0.868,0.832 and 0.759,respectively,which were 0.880,0.840 and 0.835 respectively,for LAEI,LAPEF and LAAEF.The AUC of full-volume parameters were slightly more than those of TMAD(P>0.05).Conclusion TMAD technology could be used to evaluate left atrial temporal function of SPE patients,and as a convenient and accurate method for clinical evaluation of left atrial function.