摘要 目的应用实时三维超声心动图(RT-3DE)评估射血分数保留的慢性心力衰竭(HFpEF)患者左心房功能的变化及其临床应用价值。方法选取110例慢性心力衰竭患者分为三个亚组:射血分数保留的心衰组(HFpEF),射血分数中间值的心衰组(HFmrEF),射血分数降低的心衰组(HFrEF)。同期40例健康体检者为正常对照组。测量E/E′值,左房最大容积(LAVmax)、最小容积(LAVmin),用体表面积校正得左房最大容积指数(LAVImax)、左房最小容积指数(LAVImin),计算左房射血分数(LAEF)、左房扩张指数(LAEI)。应用ELISA法测量N末端脑钠肽前体(NT-proBNP)水平。结果慢性心力衰竭患者各亚组的左室射血分数(LVEF)均较对照组低(P=0.000)。左房内径(LADd)、LAVImax、E/E′在慢性心力衰竭患者中增大,且随着左室射血分数的下降呈进行性增大(P=0.000)。LAEF、LAEI在慢性心力衰竭患者中减低,随着左室射血分数的下降呈进行性减低(P=0.000)。LAEF与E/E′、LAVImax呈负相关(P=0.000),LAEF与LAEI呈正相关(P=0.000)。左房射血分数与左房扩张指数相关性最好,且三维测量的左房参数相关性优于二维测量。结论射血分数保留的慢性心力衰竭患者左心房的结构和功能在早期已发生改变;RT-3DE比RT-2DE更能精准地评估左心房功能。 Objective To apply real-time three-dimensional echocardiography(RT-3 DE) to evaluate the changes of left atrial function in patients with chronic heart failure(HFpEF) with preserved ejection fraction and its clinical value. Methods 110 patients with chronic heart failure were divided into three subgroups: heart failure group with preserved ejection fraction(HFpEF);heart failure group with median ejection fraction(HFmrEF);heart failure group with reduced ejection fraction(HFrEF).During the same period, 40 healthy subjects were the normal control group.Measure E/E′ value, left atrial maximum volume(LAVmax), minimum volume(LAVmin), use body surface area to correct the left atrial maximum volume index(LAVImax), left atrial minimum volume index(LAVImin), and calculate the left atrial ejection fraction(LAEF), Left Atrium Expansion Index(LAEI).Measure the level of N-terminal brain natriuretic peptide(NT-proBNP) by ELISA. Results The left ventricular ejection fraction(LVEF) of each subgroup of patients with chronic heart failure was lower than that of the control group(P=0.000).Left atrial inner diameter(LADd), LAVImax, E/E′ increased in patients with chronic heart failure, and increased progressively with the decrease of left ventricular ejection fraction(P=0.000).LAEF and LAEI decreased in patients with chronic heart failure, and gradually decreased with the decrease of left ventricular ejection fraction(P=0.000).LAEF was negatively correlated with E/E′ and LAVImax(P=0.000), and LAEF was positively correlated with LAEI(P=0.000).The left atrial ejection fraction had the best correlation with the left atrial expansion index, and the correlation of left atrial parameters in three-dimensional measurement was better than that in two-dimensional measurement. Conclusions The structure and function of the left atrium of patients with chronic heart failure who have preserved ejection fraction have changed at an early stage;RT-3 DE is more accurate than RT-2 DE in assessing left atrial function.
出处 《中国超声医学杂志》 CSCD 北大核心 2021年第4期418-421,共4页 Chinese Journal of Ultrasound in Medicine
关键词 实时三维超声心动图 射血分数保留心力衰竭 左心房功能 Real-time three-dimensional echocardiography Heart failure with preserved ejection fraction Left atrial function
分类号 R54 [医药卫生—心血管疾病]
