摘要
目的探讨应用二维斑点追踪技术测定右心房(RA)心肌应变,评估慢性血栓栓塞性肺动脉高压患者RA功能及预后。方法选取40例慢性血栓栓塞性肺动脉高压患者(CTEPH组)和20例相匹配的健康者(对照组)。应用二维斑点追踪技术测定RA应变参数:RA舒张期正向应变(RALSpos)、RA主动收缩期负向应变(RALSneg)、RALSpos与RALSneg绝对值之和(RALStot)、RA纵向应变率(RALSR);应用超声心动图获得RA常规功能参数:RA整体排空分数(RATEF)、RA被动排空分数(RAPEF)、RA主动排空分数(RAAEF)、RA每搏量(RASV)、RA主动排空容积(RAAEV)、RA被动排空容积(RAPEV)、右心室(RV)流出道速度-时间积分(RVOTVTI),容积参数均由体表面积校正为相应指数。分析RA心肌应变与右心结构、功能之间的关系。结果CTEPH组的RALStot、RALSpos、RALSR与对照组比较都明显降低(P<0.01),RATEF、RAPEF、RAAEF、RAFi与对照组比较也都有明显降低(P<0.01),而RASVI、RAAEVI与对照组比较明显升高(P<0.01);CTEPH组RA、RV均增大组与RA增大、RV正常组和RA、RV均正常组比较,RALStot、RALSpos都有明显降低(P<0.05);CTEPH组,无论RA、RV是否增大,RV功能参数和应变参数与对照组比较,均有显著差异(P<0.05);RALStot、RALSpos与RALSR、RAS、RV功能参数、RV应变参数均存在相关性(P<0.05),与反映RA整体功能的RAFi存在较高相关性(|r|>0.5,P<0.01)。结论RA心肌应变参数可以早期评估CTEPH患者的RA功能,与右心结构、功能参数之间存在良好的相关性,并提示预后。
Objective To measure right atrial myocardial strain using two-dimensional speckle tracking technique to assess right atrial function and prognosis in patients with chronic thromboembolic pulmonary hypertension.Methods We collected 40 patients with chronic thromboembolic pulmonary hypertension and 20 matched healthy patients.The strain parameters of the right atrium were determined by two-dimensional speckle tracking technique positive diastolic strain(RALSpos),positive systolic strain(RALSneg),sum of absolute value of RALSpos and RALSneg(RALStot),strain rate of the right atrium(RALSR);the normal function parameters of the right atrium were obtained by echocardiography in terms of the whole emptying fraction of the right atrium(RATEF),the passive emptying fraction of the right atrium(RAPEF),the active emptying fraction of the right atrium(RAAEF),the active emptying volume of the right atrium(RASV),the active emptying volume of the right atrium(RAAEV),the passive emptying volume of the right atrium(RAPEV),Velocity-time integration of right ventricular outflow tract(RVOTVTI),and volume parameters are corrected from body surface area to corresponding index.We analyzed the relationship between right atrial myocardial strain and cardiac structure and function.Results The RALStot,RALSpos,RALSR of CTEPH patients decreased significantly compared with the control group(P<0.01),RATEF,RAPEF,RAAEF or RAFi was also significantly lower than control group(P<0.01),while RASVI,or RAAEVI was significantly higher than control group(P<0.01);the RALStot,RALSpos of CTEPH patients with enlargement of right atrium and right ventricle were significantly lower than those of normal right atrium and right ventricle(P<0.05);For CTEPH patients,whether the right atrium and right ventricle increased or not,the function and strain parameters of the right ventricle were significantly different from those of the control group(P<0.05);RALStot,or RALSpos was associated with RALSR,RAS and right ventricular function and strain parameters(P<0.05);there was a correlation between RALStot,RALSpos and RALSR,RAS,right ventricular function and strain parameters(P<0.05),and a high correlation with the RAFi reflecting the overall function of right atrium(|r|>0.5,P<0.01).Conclusion Strain parameters of right atrial myocardium can be used to evaluate the right atrial function in CTEPH patients early,and there is a good correlation between the right atrial structure and functional parameters,which can indicate the prognosis.
作者
袁华
荆艳艳
王丽红
YUAN Hua;JING Yanyan;WANG Lihong(Deparment of Ultrasound, Yantai Yuhuangding Hospital, Affiliated to Qingdao University, Yantai 264000, P.R.China;Deparment of Cardiology, Yantai Yuhuangding Hospital, Affiliated to Qingdao University, Yantai 264000, P.R.China)
出处
《医学影像学杂志》
2021年第10期1686-1690,共5页
Journal of Medical Imaging
关键词
超声心动图
慢性血栓栓塞性肺动脉高压
右心房功能
二维斑点追踪技术
Ultrasound cardiogram
Chronic thromboembolic pulmonary hypertension
Right atrial function
Two-dimensional speckle tracking technology
作者简介
袁华(1983-),女,青岛大学医学院在读硕士研究生,主治医师,主要从事超声诊断工作;通信作者:王丽红,E-mail:wangwangjn168@163.com。
