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同一健康成年人二尖瓣和三尖瓣环的尺寸及功能特征比较:三维斑点追踪超声心动图MAGYAR-健康研究的见解

Comparison of dimensions and functional features of mitral and tricuspid annuli in the same healthy adults: insights from the three-dimensional speckle-tracking echocardiographic MAGYAR-Healthy Study.

作者信息

Nemes Attila, Kormányos Árpád, Lengyel Csaba

机构信息

Department of Medicine, Albert Szent-Györgyi Medical School, University of Szeged, Szeged, Hungary.

出版信息

Quant Imaging Med Surg. 2024 Sep 1;14(9):6780-6791. doi: 10.21037/qims-24-630. Epub 2024 Aug 22.

Abstract

BACKGROUND

Evaluation of mitral (MA) and tricuspid annuli (TA) in the same healthy subject in a non-invasive way in real-life clinical settings makes an opportunity to compare their dimensions and derived functional properties. The purpose of the present cohort study was to investigate whether there are any differences in the three-dimensional speckle-tracking echocardiography- (3DSTE-) measured size and derived functional characteristics of the MA and TA in the same healthy adults.

METHODS

The study comprised 248 healthy adults, in which 3DSTE was performed to determine MA and TA dimensions and functional properties. Due to insufficient image quality, 89 cases were excluded, therefore the remaining population consisted of 159 subjects (age: 35.6±12.9 years, 76 males). Subjects were enrolled on a voluntary basis consecutively between January 2011 and November 2017 in the outpatient clinic of the tertiary cardiology center at the Department of Medicine, University of Szeged, Hungary. Data were analyzed by Student's -test, analysis of variance (ANOVA) test, Fischer's exact test, Pearsons' correlations, interclass correlations and Bland-Altman tests.

RESULTS

Same-side MA/TA end-diastolic annular dilation is associated with simultaneous MA/TA end-systolic dilation and vice versa. MA dilation in end-diastole and end-systole results in MA functional improvement/deterioration. Dilation of end-diastolic TA dimensions does not obviously entail differences in TA function. However, similar to MA, more dilated TA in end-systole is associated with impaired TA function. Dilated MA dimensions (end-diastolic MA area: 4.31±0.62 10.89±1.18 cm, P<0.05) are not obviously associated with dilated end-diastolic TA dimensions (area: 7.05±1.42 7.81±1.48 cm, P=ns) and functional improvement/impairment (fractional area change: 27.5%±10.8% 25.2%±10.6%, P=ns).

CONCLUSIONS

Dilation of MA and TA is associated with different contralateral responses in morphology and function.

摘要

背景

在现实临床环境中,以非侵入性方式对同一健康受试者的二尖瓣(MA)和三尖瓣环(TA)进行评估,为比较它们的尺寸和衍生的功能特性提供了契机。本队列研究的目的是调查在同一健康成年人中,三维斑点追踪超声心动图(3DSTE)测量的MA和TA尺寸及其衍生的功能特征是否存在差异。

方法

该研究纳入了248名健康成年人,对其进行3DSTE以确定MA和TA的尺寸及功能特性。由于图像质量不足,排除了89例,因此剩余人群包括159名受试者(年龄:35.6±12.9岁,男性76名)。2011年1月至2017年11月期间,受试者在匈牙利塞格德大学医学系三级心脏病中心门诊自愿连续入组。数据采用学生t检验、方差分析(ANOVA)、费舍尔精确检验、皮尔逊相关性分析、组内相关性分析和布兰德-奥特曼检验进行分析。

结果

同侧MA/TA舒张末期瓣环扩张与同时期MA/TA收缩末期扩张相关,反之亦然。MA舒张末期和收缩末期的扩张导致MA功能改善/恶化。TA舒张末期尺寸的扩张并未明显导致TA功能的差异。然而,与MA相似,TA收缩末期扩张越明显,其功能受损越严重。MA尺寸扩张(舒张末期MA面积:4.31±0.62对10.89±1.18 cm,P<0.05)与舒张末期TA尺寸扩张(面积:7.05±1.42对7.81±1.48 cm,P=无统计学意义)及功能改善/受损(面积变化分数:27.5%±10.8%对25.2%±10.6%,P=无统计学意义)无明显关联。

结论

MA和TA的扩张与形态和功能方面不同的对侧反应相关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/52a4/11400638/49dda9d756ce/qims-14-09-6780-f1.jpg

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