Ge X Y, Shao L, Zheng Z L
Ningbo Medical Center Lihuili Eastern Hospital, Ningbo 315000, China.
Zhonghua Yi Xue Za Zhi. 2016 Dec 20;96(47):3815-3818. doi: 10.3760/cma.j.issn.0376-2491.2016.47.010.
To evaluate right atrial function in systemic lupus erythematosus (SLE) with normal pulmonary pressure by using two dimensional-speckle tracking imaging (2D-STI) and real-time three-dimensional echocardiography(RT-3DE). A totoal of 40 patients with SLE and 40 control subjects were collected between December 2011 and May 2014 from Ningbo Medical Treatment Center Lihuili Hospital. Right atrial global longitudinal strain (RAGLS) and all kinds of right atrium volume index (RAVI) were detected. Relationship between tricuspid annular plane systolic excursion(TAPSE), tricuspid annulus systolic peak velocity (S'), right ventricular myocardial performance index (RVMPI), E/e' and the right atrium parameters were analyzed. SLE group's right atrium maximal volume index(RAVImax)(33.5±11.1) ml/m right atrium minimal volume index (RAVImin)(13.2±4.5) ml/m right atrium presystolic volume index (RAVIpre) (2.57±10.2) ml/m right atrium total emptying volume index(RAVIt)(20.2±8.1)ml/m right atrium active emptying volume index (RAVIa)(12.5±7.5) ml/m) were increased .But right atrium passive emptying volume index(RAVIp)( 7.8±2.7) ml/m and right atrial global longitudinal strain (RAGLS) (38.2%±7.7% ) were decreased (both <0.05). RAGLS was positive correlated with S' and TAPSE, the value were 0.565 and 0.445 respectively (both <0.01). E/e' was positive correlated with RAVIpre, RAVIa, the value were 0.469 and 0.481 respectively (both <0.05). Detecting right atrial function by 2D-STI and RT-3DE could diagnose right atrial dysfunction in early stage of SLE patients with normal pulmonary pressure. The method is simple, has significant clinical value.
采用二维斑点追踪成像（2D-STI）和实时三维超声心动图（RT-3DE）评估肺动脉压正常的系统性红斑狼疮（SLE）患者的右心房功能。2011年12月至2014年5月期间，从宁波市医疗中心李惠利医院收集了40例SLE患者和40例对照者。检测右心房整体纵向应变（RAGLS）和各种右心房容积指数（RAVI）。分析三尖瓣环平面收缩期位移（TAPSE）、三尖瓣环收缩期峰值速度（S'）、右心室心肌做功指数（RVMPI）、E/e'与右心房参数之间的关系。SLE组右心房最大容积指数（RAVImax）（33.5±11.1）ml/m、右心房最小容积指数（RAVImin）（13.2±4.5）ml/m、右心房收缩前期容积指数（RAVIpre）（2.57±10.2）ml/m、右心房总排空容积指数（RAVIt）（20.2±8.1）ml/m、右心房主动排空容积指数（RAVIa）（12.5±7.5）ml/m均升高。但右心房被动排空容积指数（RAVIp）（7.8±2.7）ml/m和右心房整体纵向应变（RAGLS）（38.2%±7.7%）降低（均<0.05）。RAGLS与S'和TAPSE呈正相关，r值分别为0.565和0.445（均<0.01）。E/e'与RAVIpre、RAVIa呈正相关，r值分别为0.469和0.481（均<0.05）。通过2D-STI和RT-3DE检测右心房功能可诊断肺动脉压正常的SLE患者早期右心房功能障碍。该方法简单，具有重要的临床价值。
