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目的:应用实时三平面超声心动图(RT-3PE)和实时三平面应变率成像(Triplane-SRI)技术定量评价心肌梗死患者左心房整体及局部功能,探讨左心室功能的损害对左心房功能的影响。方法:A组为31例左心室射血分数(LVEF)≥50%的心肌梗死患者;B组为20例LVEF<50%的心肌梗死患者,C组为30例正常人。组织多普勒测量二尖瓣环收缩期峰值速度(Sa)、舒张早期峰值速度(Ea)和舒张晚期峰值速度(Aa)。脉冲多普勒测量二尖瓣口舒张早期峰值流速(E)、舒张晚期峰值流速(A)。RT-3PE软件获得左心房最大容积(LAVmax)、最小容积(LAVmin)、收缩前容积(LAVpre)、总排空分数(LAVt EF)、被动排空分数(LAVp EF)、主动排空分数(LAVa EF)等参数。Triplane-SRI软件获得左房前壁、侧壁、后壁、下壁和房间隔的心室收缩期、舒张早期和心房收缩期峰值应变率并计算其平均值(MSRS、MSRE和MSRA)。结果:1与C组比较,A、B两组Sa、Ea及Aa均显著减低(P<0.05),A组E峰显著减低(P<0.05),A峰显著增加(P<0.05),EA。2与C组比较,B组LAVt EF、LAVp EF及LAVa EF均显著减低(均P<0.05),A组LAVt EF、LAVp EF显著减低(P<0.05),但LAVa EF减低不显著。3与C组比较,B组各左心房壁及房间隔MSRS、MSRE及MSRA均显著减低(均P<0.05),A组各左心房壁及房间隔MSRS、MSRE均显著减低(均P<0.05),但左心房侧壁、后壁及下壁MSRA减低不显著。结论:RT-3PE和Triplane-SRI能从左心房容积和心房肌形变的角度综合评价左心房功能。
Objective: To quantitatively evaluate the global and local left atrium function in patients with myocardial infarction by real-time three-plane echocardiography (RT-3PE) and real-time triplane-SRI technique to investigate the effects of left ventricular dysfunction on left atrial function influences. Methods: A group of 31 patients with myocardial infarction with left ventricular ejection fraction (LVEF) ≥50%; B group with 20 patients with myocardial infarction (LVEF <50%) and 30 normal subjects (group C). Tissue Doppler was used to measure mitral annulus systolic peak velocity (Sa), early diastolic peak velocity (Ea) and late diastolic peak velocity (Aa). Pulmonary Doppler echocardiography was performed to measure mitral early peak diastolic velocity (E) and late diastolic peak velocity (A). The LAVmax, LAVmin, LAVpre, LAVt EF, LAVp EF and LAVa of the left atrium were obtained by RT-3PE software. EF) and other parameters. Triplane-SRI software was used to obtain the ventricular systolic, early diastolic and atrial systolic peak strain rates of left anterior chamber, side wall, posterior wall, inferior wall and atrial septum and to calculate mean values (MSRS, MSRE and MSRA). Results: Compared with group C, Sa, Ea and Aa in group A and group B were significantly decreased (P <0.05), group E in group E was significantly decreased (P <0.05), group A was significantly increased (P <0.05) A. 2 Compared with group C, the LAVt EF, LAVp EF and LAVa EF were significantly decreased in group B (all P <0.05). The LAVt EF and LAVp EF in group A were significantly decreased (P <0.05), but the decrease of LAVa EF was not significant. Compared with group C, the left atrial wall and atrial septum MSRS, MSRE and MSRA were significantly decreased in group B (all P <0.05), and the left atrial wall and atrial septal MSRS and MSRE in group A were significantly decreased (all P <0.05 ), But the left atrial wall, posterior wall and inferior wall MSRA reduction was not significant. Conclusion: RT-3PE and Triplane-SRI can be used to evaluate left atrial function in terms of left atrium volume and atrial deformation.