摘要
目的探讨采用XPLANE技术测量右心室纵向缩短分数(LSF)评估经皮介入封堵(PI)房间隔缺损(ASD)前后右心室功能变化的应用价值,分析及其影响因素。方法收集68例经超声检查诊断ASD并接受PI患者,分别于术前及术后1、3个月行超声心动图检查,采用XPLANE技术测量并比较其二腔心切面(LSF AP2)和四腔心切面(LSF AP4)图像LSF及其均值(LSF APM)、三尖瓣环收缩期位移(TAPSE)、肺动脉高压(PH)分级、右心室与左心室舒张末期内径比(RVEDD/LVEDD)分级的差异;分析LSF AP2、LSF AP4、LSF APM与TAPSE的相关性及LSF APM的影响因素。结果术后1、3个月RVEDD/LVEDD(H=76.07、77.74)及PH分级(H=42.02、49.83)均较术前降低(P均<0.05)。3个时间点之间右心室LSF AP 2、LSF AP 4、LSF APM及TAPSE差异均有统计学意义(F=6.11、3.18、8.35、20.28,P均<0.05);术前与术后3个月LSF AP4、LSF APM差异无统计学意义(P均>0.05),LSF AP2、LSF AP4、LSF APM及TAPSE两两比较差异均有统计学意义(P均<0.05)。PI前后LSF参数均与TAPSE呈正相关(P均<0.05)。年龄、术前PH分级为LSF APM的共同影响因素。结论利用XPLANE技术可有效观察ASD患者PI前后右心室功能变化。PI术后ASD患者右心室形态及功能均获改善,且术前及术后LSF参数与TAPSE变化趋势基本一致。年龄和术前PH分级为ASD患者右心功能的影响因素。
Objective To explore the application value of right ventricular longitudinal shortening fraction(LSF)obtained with XPLANE technique for evaluation on changes of right ventricular function in patients with atrial septal defect(ASD)before and after percutaneous intervention(PI),and to analyze relative impact factors.Methods Totally 68 patients with ultrasound-diagnosed ASD who accepted PI were collected.All patients underwent echocardiography before PI,1 month and 3 months after PI,respectively.Then LSF of apical plane of 2-chamber(LSF AP2)and apical plane of 4-chamber(LSF AP4)images and the mean value of LSF AP2 and LSF AP4(LSF APM),tricuspid annular plane systolic excursion(TAPSE),pulmonary hypertension(PH)grading,as well as right ventricle end-diastolic diameter/left ventricle end-diastolic diameter(RVEDD/LVEDD)grading before and after PI were measured and compared.The correlation of LSF AP2,LSF AP4,LSF APM and TAPSE,and the impact factors of LSF APM were analyzed.Results RVEDD/LVEDD(H=76.07,77.74)and PH(H=42.02,49.83)grading 1 month and 3 months after PI were lower than those before PI(all P<0.05).There were statistical differences of LSF AP4,LSF AP2,LSF APM and TAPSE in right ventricle before and after PI(F=6.11,3.18,8.35,20.28,all P<0.05).NO statistical difference was found between LSF AP4 and LSF APM before PI nor those after PI(both P>0.05).There were statistical differences of remaining LSF AP2,LSF AP4,LSF APM and TAPSE before and after PI(all P<0.05).LSF parameters before and after PI were positively correlated with TAPSE(all P<0.05).Age and preoperative PH grading were the common impact factors of LSF APM before and after PI.Conclusion XPLANE technique can be used to effectively observe the changes of right ventricular function in patients with ASD before and after PI.The morphology and function of right ventricle in patients can be improved with PI,and the variation trend of LSF parameters and TAPSE before and after PI are basically similar.Age and preoperative PH grading are impact factors of right heart function before and after PI.
作者
刘晗
刘安宁
李玉宏
LIU Han;LIU Anning;LI Yuhong(Department of Ultrasound,the First Affiliated Hospital of Jinzhou Medical University,Jinzhou 121001,China)
出处
《中国医学影像技术》
CSCD
北大核心
2020年第6期844-848,共5页
Chinese Journal of Medical Imaging Technology
基金
辽宁省自然科学基金(20170540381)
辽宁省兴辽英才计划(XLYC1802049)。
关键词
心脏缺损
先天性
心室功能
右
介入治疗
超声检查
heart defects,congenital
ventricular function,right
interventional therapy
ultrasonography
