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目的应用左心房(左房)追踪技术(LAVT)对成人继发孔型房间隔缺损(S-ASD)患者左房功能与肺动脉收缩压(PASP)的相关性进行评价。方法 50例伴肺动脉高压的成人S-ASD患者,其中轻度18例,中度22例,重度10例,分别采集并储存标准心尖两腔心、心尖四腔心动态二维图像,运用LAVT技术获得左房容积-时间曲线和容积变化速率曲线。记录时间曲线上左房最大容积(LAVmax)、最小容积(LAVmin)及收缩前容积(LAVpre),用体表面积(BSA)对以上的容积指标进行校正,得到相应的容积指数:LAVImax、LAVIpre、LAVImin,计算左房整体、被动、主动排空量(LAVItotal、LAVIpass、LAVIact),整体、被动、主动排空分数(LAVIt EF、LAVIp EF、LAVIa EF)。记录容积变化速率曲线的舒张早期排空速率峰值(dv/dt E)、舒张晚期排空速率峰值(dv/dt A),收缩期充盈速率峰值(dv/dt S)。结果 S-ASD患者的LAVItotal、LAVIt EF、dv/dt S、LAVIact、LAVIa EF与PASP呈负相关(P<0.05),dv/dt A、LAVIpass、LAVIp EF、dv/dt E与PASP无明显相关性(P>0.05)。结论 LAVT技术能够准确的评价S-ASD患者左房功能与PASP的相关性,为临床提供有价值的信息。
Objective To evaluate the relationship between left atrial function and pulmonary artery systolic pressure (PASP) in patients with adult secondary atrial septal defect (S-ASD) using left atrium tracking (LAVT). Methods Fifty adult S-ASD patients with pulmonary hypertension were treated with LAVT technique, including 18 mild cases, 22 moderate cases and 10 severe cases. Two kinds of standard two-chamber heart and apical four- Obtain left atrium volume - time curve and volume change rate curve. The LAVmax, LAVmin and LAVpre were recorded on the time curve, and the above volume index was corrected by BSA to obtain the corresponding volume index: LAVImax, LAVIpre, LAVImin Total left atrium, passive, active emptying volume (LAVItotal, LAVIpass, LAVIact), total, passive and active emptying scores (LAVIt EF, LAVIp EF, LAVIa EF) were calculated. The dv / dt E peak, the dv / dt A peak and the dv / dt S peak of the early diastolic velocity were recorded. Results The LAVItotal, LAVIt EF, dv / dt S, LAVIact and LAVIa EF of patients with S-ASD were negatively correlated with PASP (P <0.05). There was no significant correlation between dAV / dt A, LAVIpass, LAVIp EF and dv / (P> 0.05). Conclusion LAVT can accurately evaluate the correlation between left atrial function and PASP in patients with S-ASD and provide valuable information for clinical practice.