实用医学杂志 ›› 2022, Vol. 38 ›› Issue (19): 2476-2480.doi: 10.3969/j.issn.1006⁃5725.2022.19.019

• 医学检查与临床诊断 • 上一篇    下一篇

全自动三维超声右心室定量评价慢性肺源性心脏病患者右室收缩功能

王爽 冯艳红   

  1.  锦州医科大学附属第一医院超声医学科(辽宁锦州 121001

  • 出版日期:2022-10-10 发布日期:2022-10-10
  • 通讯作者: 冯艳红 E⁃mail:13704067100@163.com
  • 基金资助:
    辽宁省自然科学基金计划重点项目(编号:20180530009)

Evaluation of right ventricular systolic function by fully automated three ⁃ dimensional echocardiography right ventricular quantification software in patients with chronic pulmonary heart disease

WANG ShuangFENG Yanhong.   

  1. Department of Medical UltrasonicsThe First Affiliated Hospital of Jinzhou Medical UniversityJin⁃ zhou 121001China

  • Online:2022-10-10 Published:2022-10-10
  • Contact: FENG Yanhong E⁃mail:13704067100@163.com ​

摘要:

目的 探讨全自动三维超声右心室定量(3D Auto RV)评估慢性肺源性心脏病(CPHD)患者右室收缩功能的临床价值。方法 根据临床表现将 88 CPHD 患者分为代偿组(48 例)和失代偿组 (40 例),另选取健康对照组 40 例。测量受试者常规超声参数,并应用 3D Auto RV 测量右室舒张末期容积 (RVEDV)、右室收缩末期容积(RVESV)、右室每搏输出量(RVSV)、右室射血分数(RVEF)、三尖瓣环收缩期 位移(TAPSE)、右室面积变化率(RVFAC)、右室的游离壁纵向应变(FWLS)和室间隔纵向应变(SLS),比较 各组间差异。结果1)与对照组比较,CPHD 各组 TAPSERVFACRVEFFWLS SLS 均减低,RVEDVRVESV 均增大(P < 0.05);失代偿组 RVSV 较对照组及代偿组均减低(P < 0.05),代偿组 RVSV 与对照组比 较无明显差异(P > 0.05)。与代偿组相比,失代偿组TAPSERVFACRVEFFWLS均进一步减低,RVEDVRVESV 均进一步增大(P < 0.05),RVSLS 差异无统计学意义(P > 0.05)。(2FWLS RVEF 相关性较高 (r = -0.721P < 0.001)。(3RVEF 预测 CPHD 失代偿期的最佳截断值为 41.35%AUC = 0.95P < 0.001)。 (4)重复性检验显示 RVEF FWLS 具有良好的重复性。结论 3D Auto RV 能够准确评价 CPHD 患者的右 室收缩功能,有望成为临床评估CPHD 患者病情程度的新方法。

关键词: 三维超声右心室定量,  , 慢性肺源性心脏病,  , 右心室功能,  , 人工智能

Abstract:

Objective To investigate the clinical value of fully automated three⁃dimensional echocardiog⁃ raphy right ventricular quantification software3D Auto RVin evaluating right ventricular systolic function in patients with chronic pulmonary heart diseaseCPHD. Methods According to clinical manifestations88 patients with CPHD were divided into the compensated groupn = 48and the decompensated groupn = 40),and 40 healthy subjects served as controls. To measure the routine ultrasound parameters of the subjects and apply 3D Auto RV measures right ventricular end ⁃ diastolic volumeRVEDV),right ventricular end ⁃ systolic volume RVESV),right ventricular stroke volumeRVSV),right ventricular ejection fractionRVEF),tricuspid annular plane systolic excursionTAPSE),right ventricular fractional area changeRVFAC),longitudinal strain of free wallFWLS),longitudinal strain of ventricular septumSLS),and the difference among groups were compared. Results 1Compared with the control groupTAPSERVFACRVEFFWLS and SLS were decreasedwhile RVEDV and RVESV were increased in CPHD groupsP < 0.05. The RVSV of the decompensated group was significantly lower than that of the control group and the compensated patientsP < 0.05),but there was no sig⁃ nificant difference between the compensatory group and the control groupP > 0.05. Compared with the compensated groupTAPSERVFACRVEF and FWLS were further decreasedRVEDV and RVESV were further increased in the decompensated groupP < 0.05),and SLS had no significant differenceP > 0.05.2FWLS had a high correlation with RVEFr = -0.721P < 0.001.3The optimal cut⁃off value of RVEF for predicting the decompensated phase of CPHD was 41.35%AUC = 0.95P < 0.001.4Repeatability test showed that both RVEF and FWLS had good repeatability. Conclusion 3D Auto RV can accurately evaluate the right ventricularsystolic function in patients with CPHDwhich is expected to become a new method for clinical evaluation of the severity of CPHD.

Key words:

fully automated three?dimensional echocardiography right ventricular quantification, chronic pulmonary heart disease, ventricular function, right, artificial intelligence