心脏移植术后左右心室功能变化的临床价值

目的探讨心脏移植术后左右心室收缩及舒张功能的变化的临床价值。方法2000年8月至2007年6月在复旦大学附属中山医院行心脏移植后随访的患者20例，行常规超声检查；应用脉冲多普勒记录二尖瓣、主动脉瓣、三尖瓣、肺动脉瓣血流图；组织多普勒记录心尖四腔心切面图谱；实时三维超声心动图测量左心室射血分数。并与正常对照组进行比较。结果心脏移植组左房内径较正常对照组明显增大（P〈0．01），右室的Tei指数较正常对照组高（P〈0．05）。三尖瓣口血流图心脏移植组A峰的峰值速度较正常对照组高（P〈0．01），E／A比值心脏移植组较正常对照组低（P〈0．05）；三尖瓣瓣环右室侧壁的收缩速度、E峰的峰值速度、A峰的峰值速度均较正常对照组低（P〈0．01，P〈0．05，P〈0．05），E／A比值较正常对照组高（P〈0．05）；右室侧壁的收缩速度、E峰的峰值速度、A峰的峰值速度均较正常对照组低（P均〈0．05），E／A比值较正常对照组高（P〈0．05）。结论心脏移植组其右室收缩功能减退，而左室收缩功能及左右室舒张功能未见明显异常。

Echocardiographic parameters for assessing left and right ventricular function after heart transplantation

Objective To investigate the value of left and right function variety after heart transplantation. Methods Twenty heart transplants were studied on two-dimensional echoeardiography, pulsed wave Doppler, tissue Doppler and three-dimensional eehocardiography. Results Left atrial diameter in heart transplants was enlarger than normal subjects （P 〈 0. 01 ） , fight ventricular Tel index, velocity of peak A in tricuspid were higher than those of the normal subjects （ P 〈 0.05, P 〈 0. 01, respectively）, the ratio of E/A in tricuspid was lower than that of the normal subjects（ P 〈 0.05 ）, systolic velocity in tricuspid annulus and right ventrieular wall, velocity of peak E and peak A were reduced significantly compared with the normal subjects（P 〈 0. 01, P 〈 0. 05, P 〈 0. 05, respectively） , while the ratio of E/A was increased significantly compared with the normal subjects （ P 〈 0. 05 ）. Conclusions Right ventricular systolic function is reduced in heart transplant.