摘要
目的应用三维斑点追踪(3D-STI)技术评估高龄孕妇左心功能。方法选取于我院产检的高龄单胎孕妇40例(妊娠年龄≥35岁,高龄组)和同期适龄单胎孕妇35例(妊娠年龄25~29岁,适龄组),分别于早孕期(妊娠第12~14周)、中孕期(妊娠第24~27周)、晚孕期(妊娠第36~39周)采集超声心动图,获取两组各孕期常规超声心动图参数即室间隔舒张末期厚度(IVSd)、左室后壁舒张末期厚度(LVPWd)、左房内径(LAD)、左室射血分数(LVEF)、每搏输出量(SV)、心输出量(CO)、二尖瓣舒张早期和晚期峰值血流速度(E、A)、E/A、室间隔侧二尖瓣环舒张早期运动速度(e’)、左室侧壁e’、平均E/e’、三尖瓣环收缩期位移(TAPSE),以及3D-STI参数即左室整体纵向应变(GLS)、左室整体环向应变(GCS)、左室同步性指数(SDI)、左室舒张末期容积(LVEDV)、左室收缩末期容积(LVESV)、LVEF,比较两组各孕期上述参数的差异。结果适龄组晚孕期LAD、SV、CO、LVEDV均较早、中孕期增大,差异均有统计学意义(均P<0.05);高龄组中、晚孕期LAD、SV、CO、LVEDV均较早孕期增大,差异均有统计学意义(均P<0.05);高龄组各孕期GLS、GCS均降低,SDI均增高,与适龄组同孕期比较差异均有统计学意义(均P<0.05)。两组各孕期IVSd、LVPWd、LVEF、E、A、E/A、室间隔侧e’、左室侧壁e’、平均E/e’、TAPSE、LVESV比较差异均无统计学意义。结论应用3D-STI技术可早期发现高龄孕妇的亚临床左心功能损伤,是监测其妊娠期心功能变化的可靠手段。
Objective To evaluate the left ventricular function in women with advanced maternal age by three-dimensional speckle tracking imaging(3D-STI)technology.Methods Forty singleton pregnant women with advanced maternalage(pregnancy age≥35 years,advanced maternal age group)and matched 35 singleton pregnant women with appropriate age(pregnancy age 25~29 years,age-appropriate group)during the same period were selected.Echocardiographic data werecollected during early pregnancy(12~14 weeks of gestation),middle pregnancy(24~27 weeks of gestation),and late pregnancy(36~39 weeks of gestation).Interventricular septum end-diastolic thickness(IVSd),left ventricular posterior wall end-diastolicthickness(LVPWd),left atrial diameter(LAD),left ventricular ejection fraction(LVEF),stroke output(SV),cardiac output(CO),peak blood flow velocity of early and late mitral valve diastole(E,A),E/A,e’velocity of mitral annulus ventricular septum(septum e’),e’velocity on the lateral wall of the left mitral ring(lateral wall e’),mean E/e’,systolic displacement of tricuspidvalve annulus(TAPSE),and three-dimensional ultrasonic parameters including left ventricular global longitudinal strain(GLS),left ventricular global circumferential strain(GCS),left ventricular synchronization index(SDI),left ventricular end-diastolicvolume(LVEDV),end-systolic volume(LVESV),LVEF between the two groups during different pregnancy periods werecompared.Results Compared with the early and middle pregnancy,LAD,SV,CO and LVEDV were increased during the latepregnancy in age-appropriate group(all P<0.05).Compared with the early pregnancy,LAD,LVEDV,SV,CO were increased during the middle and late pregnancy in the advanced maternal age group(all P<0.05).Compared with the age-appropriate at thesame gestational week,GLS and GCS were decreased,while SDI was increased in the advanced maternal age group(all P<0.05).There were no significant differences in IVSd,LVPWd,LVEF,E,A,E/A,septum e’,lateral wall e’,mean E/e’,TAPSE,LVESVat different gestational week between the two groups.Conclusion 3D-STI is a reliable tool for the early evaluation of leftventricular function in women with advanced maternal age,and is helpful for the early detection of cardiac function changesat pregnancy.
作者
宋蕊
刘娟
陈卓
王庆慧
陈剑
丁云川
SONG Rui;LIU Juan;CHEN Zhuo;WANG Qinghui;CHEN Jian;DING Yunchuan(Department of Ultrasound,Yan’an Hospital Affiliated to Kunming Medical University,Kunming 650051,China)
出处
《临床超声医学杂志》
CSCD
2023年第2期121-125,共5页
Journal of Clinical Ultrasound in Medicine
基金
云南省教育厅科学研究基金资助项目(2020Y0135)。
关键词
超声心动描记术
斑点追踪
三维
孕妇
高龄
心功能
左
Echocardiography
Speckle tracking
three-dimensional
Pregnant women
elderly
Ventricular function
left
