左心房容积追踪技术评价风湿性心脏病二尖瓣狭窄患者左心房功能
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摘要
目的探讨左心房容积追踪(LAVT)技术评价风湿性心脏病(RHD)二尖瓣狭窄患者左心房功能变化的价值。方法选取28例RHD患者作为病例组,23例作为对照组。LAVT技术构建双平面左心房容积-时间曲线,记录左心房最大容积(LAVmax)、收缩前容积(LAVpre)及最小容积(LAVmin)。用体表面积(BSA)对容积指标标化,得到容积指数(LAVI),计算左心房总排空量(LAVItotal)、被动排空量(LAVIpass)、主动排空量(LAVIact)及左心房总排空率(%LAVItotal)、被动排空率(%LAVIpass)、主动排空率(%LAVIact)。结果与对照组比较,病例组年龄、BSA、左室舒张末内径(LVEDD)无统计学差异(P>0.05);左房内径(LAD)、LAVImax、LAVIpre、LAVImin、LAVItotal、LAVIact均增大(P<0.01);LAVIpass增加,差异无统计学意义(P>0.05);左室射血分数(LVEF)、%LAVItotal、%LAVIpass、%LAVIact减低(P<0.01)。结论 LAVT技术能准确地评价RHD二尖瓣狭窄患者左房功能的变化。
Objective To evaluate the value of left atrial volume tracking(LAVT)in assessing left atrial function in patients with rheumatic heart disease(RHD)mitral stenosis.Methods 28 RHD patients were selected as the case group,23 healthy volunteers were included as control.Left atrial volume-time curve of bi-plane was obtained by LAVT.The value of LA maximal volume(LAVmax),pre-systolic volume(LAVpre),and the minimal volume(LAVmin)were recorded on the curve.All LA volume were corrected by BSA into LA volume index(LAVI).Then LA empting volume(LAVItotal,LAVIpass,LAVIact)and empting rate(%LAVItotal,%LAVIpass,%LAVIact)were calculated.Results No statistical difference were found in age,BSA,LVEDD,and LAVIpass between the case and control group(P >0.05);Compared with the control group,LA diameter(LAD),LAVImax,LAVIpre,LAVImin,LAVItotal,LAVIact were increased(P<0.01).The ejection fraction of left ventricle(LVEF),%LAVItotal,% LAVIpass,%LAVIact declined obviously(P<0.01).Conclusions LAVT technology can accurately assess the change of left atrial function in patients with rheumatic mitral stenosis.
Objective To evaluate the value of left atrial volume tracking(LAVT)in assessing left atrial function in patients with rheumatic heart disease(RHD)mitral stenosis.Methods 28 RHD patients were selected as the case group,23 healthy volunteers were included as control.Left atrial volume-time curve of bi-plane was obtained by LAVT.The value of LA maximal volume(LAVmax),pre-systolic volume(LAVpre),and the minimal volume(LAVmin)were recorded on the curve.All LA volume were corrected by BSA into LA volume index(LAVI).Then LA empting volume(LAVItotal,LAVIpass,LAVIact)and empting rate(%LAVItotal,%LAVIpass,%LAVIact)were calculated.Results No statistical difference were found in age,BSA,LVEDD,and LAVIpass between the case and control group(P >0.05);Compared with the control group,LA diameter(LAD),LAVImax,LAVIpre,LAVImin,LAVItotal,LAVIact were increased(P<0.01).The ejection fraction of left ventricle(LVEF),%LAVItotal,% LAVIpass,%LAVIact declined obviously(P<0.01).Conclusions LAVT technology can accurately assess the change of left atrial function in patients with rheumatic mitral stenosis.
引文
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[7] MELENOVSKY V,HWANG S J,REDFIELD M M,et al.Left Atrial Remodeling and Function in Advanced Heart Failure With Preserved or Reduced Ejection Fraction[J].Circulation Heart Failure,2015,8(2):295-303.
[8]陈超容,吴棘,邓晓丽,等.实时三维超声心动图评价舒张性心力衰竭患者左房容积及功能变化[J].中国超声医学杂志,2016,32(5):421-425.
[2] LEE S L,DAIMON M,NAKAO T,et al.Factors influencing left atrial volume in a population with preserved ejection fraction:Left ventricular diastolic dysfunction or clinical factors[J].Journal of Cardiology,2016,68(4):275-281.
[3]苏军芳,张军,王银,等.应用应变率成像技术对尿毒症患者左房功能的评价[J].中国超声医学杂志,2015,31(8):719-721.
[4]李英涛,章蓉,刘伟刚,等.三维斑点追踪技术评价尿毒症患者左心房收缩功能[J].中国超声医学杂志,2018,34(3):225-227.
[5] NAGUEH S F,SMISETH O A,APPLETON C P,et al.Recommendations for the Evaluation of Left Ventricular Diastolic Function by Echocardiography:An Update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging[J].Journal of the American Society of Echocardiography,2016,29(4):277-314.
[6] TELFORD L H,ABDULLAHI L H,OCHODO E A,et al.Standard echocardiography versus handheld echocardiography for the detection of subclinical rheumatic heart disease:protocol for a systematic review[J].Bmj Open,2018,8(2):e020140.
[7] MELENOVSKY V,HWANG S J,REDFIELD M M,et al.Left Atrial Remodeling and Function in Advanced Heart Failure With Preserved or Reduced Ejection Fraction[J].Circulation Heart Failure,2015,8(2):295-303.
[8]陈超容,吴棘,邓晓丽,等.实时三维超声心动图评价舒张性心力衰竭患者左房容积及功能变化[J].中国超声医学杂志,2016,32(5):421-425.