三维全容积技术评价健康成人左心房 容积和功能的临床研究

Evaluation of left atrial volume function in healthy adults by three-dimensional full-volume technique

摘要:

目的 应用全容积成像（FVI）技术对不同年龄段正常成人左心房容积（LAV）和功能进行评价分析。 方法 132 例健康成人按年龄段分成青年组43 例、中年组45 例和老年组44 例。常规超声测量收缩末期左心 房各径线和面积，计算LAV 和容积指数（LAVI）；记录二尖瓣口血流E 峰、A 峰和组织多普勒二尖瓣环室间 隔侧e 峰、a 峰，并计算E/A、e/a 和E/e ；三维探头采集动态心尖四腔心，分别描记每个心动周期舒张和收缩 末期的左心房内膜，系统自动分析出容积- 时间曲线，记录左心房最大容积（LAVmax）、P 波相对应的左心 房主动收缩前容积（LAVpre）和左心房最小容积（LAVmin）；计算LAV 功能各参数并进行标化。结果 二 尖瓣口血流测值E/A 及组织多普勒测值e/a 随着年龄的增加逐渐降低（P <0.05）。E/A 值与e/a 值呈正相 关（r =0.746，P =0.000）。与青年组比较，中、老年组LAVImax、LAVmin、LAVImin、LAVpre 及LAVIpre 升 高，而iLAVe、iLAVIe、LApEF、LAItEF 及LAIpEF 降低（P <0.05）；中年组与老年组比较，差异无统计学 意义（P >0.05）。LAVImax 与E/e 呈正相关（r =0.463，P =0.007），与e/a 呈负相关（r =-0.392，P =0.031）。 结论 实时三维FVI 技术为临床定量评价LAV 功能提供依据，对心血管疾病治疗方法的选择、疗效的评价和 预后评估有重要作用。

Abstract:

Objective To evaluate and analyze left atrial function in normal adults of different ages by fullvolume imaging (FVI). Methods A total of 132 healthy adults were divided into three groups according to age, 43 in the youth group, 45 in the middle age group and 44 in the elderly group. Conventional ultrasound was used to measure the diameter lines and area of the left atrium at the end of contraction, and the left atrial volume (LAV) and volume index (LAVI) of the left atrium were calculated. E and A peak were recorded at the mitral orifice, and e and a peaks at the ventricular septal side of the doppler mitral annulus were recorded, and E/A, e/a and E/e were calculated. 3D probe collected four cavity core image, which recorded for each cardiac cycle at diastolic and end-systolic stages of left atrial endometrium, and the system automatically analyzed volume-time curve, recorded left atrium (LAVmax), P wave maximum volume corresponding to the left atrial olume index (LAVpre) and left atrium minimum volume (LAVmin). Left atrial volume index function can be computed parameters and standardized. Results The Mitral blood flow value E/A and tissue doppler value e/a were reduced with age, and the difference was statistically significant (P < 0.05). There was a good correlation between the measured E/A value and the e/a value, the correlation coefficient was 0.746. Compared with the youth group, the measured values of LAVImax, LAVmin, LAVImin, LAVpre and LAVIpre in the middle and old age groups were generally increased, while those of iLAVe, iLAVIe, LApEF, LAItEF and LAIpEF were generally decreased, with statistically significant differences (P < 0.05). There was no statistically significant difference between the middle-aged group and the elderly group (P > 0.05). LAVImax was positively correlated with E/e, and negatively correlated with e/a. Conclusions Real-time three-dimensional FVI technology provides a basis for clinical quantitative evaluation of left atrial volume function and plays an important role in the selection of treatment methods for cardiovascular diseases, the evaluation of treatment effect and the evaluation of prognosis.