Menzel T, Kramm T, Brückner A, Mohr-Kahaly S, Mayer E, Meyer J
2nd Medical Clinic (Department of Cardiology), Johannes Gutenberg University, Langenbeckstrasse 1, D-55101 Mainz, Germany.
Eur J Echocardiogr. 2002 Mar;3(1):67-72. doi: 10.1053/euje.2001.0129.
Evaluation of a three-dimensional reconstruction method to show the changes of right ventricular volume and systolic function when patients undergo pulmonary thromboendarterectomy for chronic thromboembolic pulmonary hypertension.
In the examination of 11 patients (four female, seven male; age 56+/-10 years) before and after pulmonary thromboendarterectomy, end-diastolic and end-systolic right ventricular volumes were determined as a sum total of the calculated volumes of derived parallel slices of the right ventricle. Using a Tomtec workstation and a Vingmed CFM 800 echocardiography device, the acquired data were ECG-and respiration-triggered in the course of transthoracic examination, using step intervals of 5 degrees. The ventricular outline was traced manually on 5mm slices from longitudinal cut planes. For subsequent correction, their area measurements were displayed and the volume cross-checked against the volume from orthogonal cut planes. End-diastolic and end-systolic volumes could be quantified in 11/11 cases before surgery, but data could only be attained for 9/11 patients after surgery, because a limited apical window rendered the postoperative three-dimensional reconstruction impossible in two cases. Before surgery, right ventricular size was larger than normal and systolic function was clearly impaired in all of the patients (end-diastolic volume: 121+/-37 ml; end-systolic volume 91+/-30 ml; ejection fraction 25+/-8%). The decrease in mean pulmonary artery pressure after surgery was significant (47+/-8 vs 26+/-8 mmHg; P<0.05). End-diastolic and end-systolic right ventricular volumes had been reduced (80+/-33 ml and 54+/-31 ml respectively), and the ejection fraction had increased (36+/-9%).
Successfully performed pulmonary thromboendarterectomy leads to a significant reduction of right ventricular chamber size and improvement of systolic function, which can be determined with great precision and quite easily, using transthoracic three-dimensional echocardiography. Published by Elsevier Science Ltd. All rights reserved.
评估一种三维重建方法，以显示慢性血栓栓塞性肺动脉高压患者接受肺动脉血栓内膜剥脱术时右心室容积和收缩功能的变化。
在对11例患者（4例女性，7例男性；年龄56±10岁）进行肺动脉血栓内膜剥脱术前后的检查中，舒张末期和收缩末期右心室容积通过计算右心室平行衍生切片的总体积来确定。使用Tomtec工作站和Vingmed CFM 800超声心动图设备，在经胸检查过程中，以5度的步长间隔对采集的数据进行心电图和呼吸触发。在纵向切面的5毫米切片上手动描绘心室轮廓。为了进行后续校正，显示其面积测量值，并将体积与正交切面的体积进行交叉核对。术前11/11例患者的舒张末期和收缩末期容积均可量化，但术后仅9/11例患者获得了数据，因为有限的心尖窗使2例患者术后无法进行三维重建。术前，所有患者的右心室大小均大于正常，收缩功能明显受损（舒张末期容积：121±37毫升；收缩末期容积91±30毫升；射血分数25±8%）。术后平均肺动脉压显著降低（47±8 vs 26±8 mmHg；P<0.05）。舒张末期和收缩末期右心室容积均减小（分别为80±33毫升和54±31毫升），射血分数增加（36±9%）。
成功实施的肺动脉血栓内膜剥脱术可导致右心室腔大小显著减小，收缩功能改善，使用经胸三维超声心动图可以非常精确且容易地确定这些变化。由爱思唯尔科学有限公司出版。保留所有权利。
