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[通过放射性核素心室断层造影术评估右心室功能状态]

[Assessment of the functional state of the right ventricle by radionuclide tomoventriculography].

作者信息

Lishmanov Iu B, Zavadovskiĭ K V

出版信息

Klin Med (Mosk). 2011;89(3):38-43.

Abstract

The aim of this work was to evaluate the potential of radionuclide tomoventriculography (RTVG) for the study of the functional state of right ventricle (RV) in patients with thromboembolism of branches of the pulmonary artery (TEPA) or ventricular arrhythmias. A total of 96 patients were admitted for examination to the clinics of Research Institute of Cardiology, Siberian Division of Russian Academy of Medical Sciences in 2006-2008. They were divided into 3 groups. Group 1 (n = 40) included patients of mean age 62 +/- 11 years with non-massive TEPA, group 2 (n = 15) patients with coronary heart disease NYHA class I-II (50 +/- 9 years), group 3 (n = 4) children and adolescents 13.2 +/- 3.7 years with ventricular extrasystole and/or monomorphic ventricular tachycardia. All patients were examined by ECG-synchronized RTVG. The study showed that this method can be used to efficaciously determine volume characteristics of right ventricle, ejection fraction, relationship between fast and slow filling phases, and intreventricular dyssynchronism. The functional ability of the right side of the heart in patients with minor lesions in the pulmonary vasculature should be regarded as a sign of acute thromboembolism and marked systole-diastolic dysfunction of right ventricle (under similar conditions) as a manifestation of chronic post-thromboembolic hypertension. The number of areas of asynchronous myocardial contractions and the degree of intraventricular dyssynchronism detected by RTVG positively correlate with the degree of contractile dysfunction of right ventricle. Scintiographic signs of intraventricular dyssynchronism suggest predominance of contractile heterogeneity of right ventricle over physiological one.

摘要

这项工作的目的是评估放射性核素心室造影(RTVG)在研究肺动脉分支血栓栓塞(TEPA)或室性心律失常患者右心室(RV)功能状态方面的潜力。2006年至2008年,共有96名患者被送往俄罗斯医学科学院西伯利亚分院心脏病学研究所的诊所进行检查。他们被分为3组。第1组(n = 40)包括平均年龄为62±11岁的非大面积TEPA患者,第2组(n = 15)为纽约心脏协会I-II级冠心病患者(50±9岁),第3组(n = 4)为13.2±3.7岁患有室性早搏和/或单形性室性心动过速的儿童和青少年。所有患者均接受了心电图同步RTVG检查。研究表明,该方法可有效测定右心室的容积特征、射血分数、快速充盈期与缓慢充盈期之间的关系以及心室内不同步性。肺血管轻度病变患者的右心功能应被视为急性血栓栓塞的标志,而在类似情况下右心室明显的收缩-舒张功能障碍则是慢性血栓栓塞后高血压的表现。RTVG检测到的心肌异步收缩区域数量和心室内不同步程度与右心室收缩功能障碍程度呈正相关。心室内不同步的闪烁造影征象表明右心室收缩异质性超过生理性异质性。

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