Li Yuman, Xie Mingxing, Wang Xinfang, Lv Qing, Lu Xiaofang, Yang Yali, Ma Hong, Fang Lingyun, Zhang Jing, Li Weiqin
Department of Ultrasonography, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China.
J Huazhong Univ Sci Technolog Med Sci. 2010 Feb;30(1):126-31. doi: 10.1007/s11596-010-0123-3. Epub 2010 Feb 14.
Quantification of right ventricular (RV) volume and function remains a challenge because of RV complex geometry by conventional echocardiography. The purpose of this study was to assess RV global longitudinal function in patients with tetralogy of Fallot (TOF) by 2-dimensional ultrasound speckle tracking imaging (STI). Thirty-eight patients with TOF were enrolled in this study and divided into child group (n=25) and adult group (n=13) according to age. Thirty-eight age- and sex-matched normal subjects were selected as control groups including child control group (n=25) and adult control group (n=13). RV global longitudinal peak systolic strain (GLS), strain rate (GLSR(s)), early diastolic strain rate (GLSR(e)) and late diastolic strain rate (GLSR(a)) were measured in all subjects by STI from the apical 4-chamber view and compared between groups. Furthermore, the main factors affecting the RV global longitudinal functional parameters were assessed. Compared with those in controls, RV GLS, GLSR(s) and GLSR(e) were significantly reduced in patients with TOF (P<0.05 for all). RV GLSR(s) was significantly decreased in adult patients with TOF as compared with that in child patients (P<0.05). There was no significant difference in RV GLS, GLSR(e) and GLSR(a) between child and adult TOF groups (P>0.05). The diameter of right ventricle, main pulmonary artery and ventricular septum defect had correlations with RV GLSR(s) (r ( 1 )=-0.490, r ( 2 )=0.580, r ( 3 )=-0.528, respectively, P<0.05 for all). Tricuspid annular plane peak systolic velocity (Sm) was the independent predictor of RV global strain and strain rate (beta(1)=0.355, P (1)=0.031, beta(2)=0.307, P (2)=0.021). RV global longitudinal function is decreased in patients with TOF, especially in adult patients. STI is a sensitive and accurate technique in RV global functional assessment.
由于右心室（RV）复杂的几何形状，通过传统超声心动图对其容积和功能进行量化仍然是一项挑战。本研究的目的是通过二维超声斑点追踪成像（STI）评估法洛四联症（TOF）患者的右心室整体纵向功能。本研究纳入了38例TOF患者，并根据年龄分为儿童组（n = 25）和成人组（n = 13）。选择38例年龄和性别匹配的正常受试者作为对照组，包括儿童对照组（n = 25）和成人对照组（n = 13）。通过STI从心尖四腔视图测量所有受试者的右心室整体纵向收缩期峰值应变（GLS）、应变率（GLSR(s)）、舒张早期应变率（GLSR(e)）和舒张晚期应变率（GLSR(a)），并进行组间比较。此外，评估了影响右心室整体纵向功能参数的主要因素。与对照组相比，TOF患者的右心室GLS、GLSR(s)和GLSR(e)显著降低（均P < 0.05）。与儿童TOF患者相比，成人TOF患者的右心室GLSR(s)显著降低（P < 0.05）。儿童和成人TOF组之间的右心室GLS、GLSR(e)和GLSR(a)无显著差异（P > 0.05）。右心室、主肺动脉直径和室间隔缺损与右心室GLSR(s)相关（r(1) = -0.490，r(2) = 0.580，r(3) = -0.528，均P < 0.05）。三尖瓣环平面收缩期峰值速度（Sm）是右心室整体应变和应变率的独立预测因子（β(1) = 0.355，P(1) = 0.031，β(2) = 0.307，P(2) = 0.021）。TOF患者的右心室整体纵向功能降低，尤其是成人患者。STI是右心室整体功能评估中一种敏感且准确的技术。
