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中华医学超声杂志（电子版）

中华医学超声杂志（电子版） ›› 2015, Vol. 12 ›› Issue (04) : 283 -287. doi: 10.3877/cma.j.issn.1672-6448.2015.04.007

所属专题： 文献；

心血管超声影像学

实时三维超声心动图对健康人右心功能的初步探讨
蔡婕1, 汪芳1,†(), 张瑞生1, 刘航宇1, 王海燕1, 尹冬梅1, 李靖1, 臧为二1   
  1. 1. 100730　北京医院心血管内科
  • 收稿日期:2014-12-23 出版日期:2015-04-01
  • 通信作者: 汪芳
  • 基金资助:
    国家"十二五"科技支撑课题(2011BAI11B17)

Preliminary discussion of national normal right ventricular function by real-time three-dimensional echocardiography

Jie Cai1, Fang Wang1,†(), Ruisheng Zhang1, Hangyu Liu1, Haiyan Wang1, Dongmei Yin1, Jing Li1, Weier Zang1   

  1. 1. Department of Cardiovascular, Beijing Hospital, Beijing 100730, China
  • Received:2014-12-23 Published:2015-04-01
  • Corresponding author: Fang Wang
  • About author:
    Corresponding author: Wang Fang, Email:
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蔡婕, 汪芳, 张瑞生, 刘航宇, 王海燕, 尹冬梅, 李靖, 臧为二. 实时三维超声心动图对健康人右心功能的初步探讨[J]. 中华医学超声杂志（电子版）, 2015, 12(04): 283-287.

Jie Cai, Fang Wang, Ruisheng Zhang, Hangyu Liu, Haiyan Wang, Dongmei Yin, Jing Li, Weier Zang. Preliminary discussion of national normal right ventricular function by real-time three-dimensional echocardiography[J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2015, 12(04): 283-287.

目的

探讨单心动周期实时三维超声心动图测量健康人右心室容积及收缩功能的可行性及准确性。

方法

应用三维矩阵探头采集122名健康成人的右心室、左心室三维图像，使用RV Analysis及LV Analysis软件分别检测左、右心室收缩功能参数，包括收缩末期容积（ESV）、舒张末期容积（EDV）、每搏心输出量（SV）及射血分数（EF），将多种参数（性别、年龄、体表面积）分别与右心室功能参数进行相关分析，同时将左心室及右心室各参数进行比较及相关分析，验证实时三维超声心动图测量右心室功能的可靠性。

结果

健康人三维右心室EF为（55.66±13.97）%，EDV为（68.24±40.19）ml，ESV为（30.09±19.14）ml，SV为（38.30±26.10）ml；男性受试者右心室SV、EF高于女性，但无统计学差异[（40.15±26.15） ml vs （36.11±25.60） ml，（55.69±14.57）% vs （55.62±13.36）%，P均>0.05]；右心室的相关功能参数与受试者年龄无相关性（P>0.05）；体表面积（BSA）与右室EDV、ESV及SV呈弱相关性（r=0.236、0.247、0.178，P均<0.05），但与右心室EF无相关性（P>0.05）。左心室SV与右心室SV及左心室EDV与右心室EDV之间存在弱正相关关系（r=0.201、0.215，P均<0.05）。双室的EF之间及ESV之间无相关性（P>0.05)。

结论

单心动周期实时三维超声心动图技术是一种简单易行的评价右心功能的方法，能较准确地评估右心室的收缩功能。

关键词: 超声心动描记术，三维, 右心室, 收缩功能
Objective

To validate the feasibility and accuracy of right ventricular (RV) volume and systolic function with single cardiac cycle real-time three-dimensional (3D) echocardiography.

Methods

Three-dimensional images of RV and left ventricle (LV) were obtained in 122 healthy adults by 3D matrix array transducer. The end systolic volume (ESV), end diastolic volume (EDV), stroke volume (SV) and ejection fraction (EF) were measured by RV analysis and LV analysis software. To validate the reliability of measurement of right ventricle by real-time three-dimensional echocardiography, the correlations of RV functional parameters and multiple parameters (such as age, gender and body surface area) were analyzed. And the correlation and difference between different modalities of left ventricle and right ventricle were compared.

Results

3D-RVEF was (55.66±13.97)%, 3D-RVEDV was (68.24±40.19) ml, 3D-RVESV was (30.09±19.14) ml and 3D-RVSV was (38.30±26.10) mL. RVSV and RVEF of normal men were larger than those of normal women, but no statistical difference were found [(40.15±26.15) ml vs (36.11±25.60) ml, (55.69±14.57)% vs (55.62±13.36)%, both P>0.05]. RV related function parameters had no relevant correlation with age (P>0.05). Body surface area was weakly related to RVEDV, RVESV and RVSV (r=0.236, 0.247 and 0.178, all P<0.05). BSA had no correlation with RVEF. 3D-RVSV and 3D-RVEDV were weakly positively correlated with 3D-LVSV and 3D-LVEDV (r=0.215 and 0.201, both P<0.05). 3D-RVEF and 3D-RVESV were not correlate with 3D-LVEF and 3D-LVESV.

Conclusion

The single cardiac cycle real-time three-dimensional echocardiography is a simple and feasible method for assessment of right ventricular function and can quantify right ventricular contractive function precisely.

Key words: Real-time echocardiography, Right ventricle, Contractive function
图1 健康人实时三维超声心动图心尖四腔心切面图像
图2 健康人右心室分析标定三尖瓣、二尖瓣及左心室心尖区中点示意图
图3 健康人右心室三维图像、容积、射血分数参数及右心室容积变化曲线
表1 不同性别健康人左心室EF及SV比较
受试者性别 人数（名） EF（%） SV（mL）
男性 66 55.69±14.57 40.15±26.15
女性 56 55.62±13.36 36.11±25.60
t值 ? 0.053 1.681
P值 ? 0.958 0.095
表2 健康人右心室功能参数与年龄及BSA的Pearson相关分析
右心室功能参数 年龄 BSA
r值 P值 r值 P值
EDV 0.067 0.465 0.236 0.009
ESV 0.032 0.723 0.247 0.006
SV 0.047 0.608 0.178 0.049
EF 0.027 0.765 -0.081 0.377
表3 健康人左心室与右心室功能参数的比较
心室 EDV ESV SV EF
右心室 66.97±39.32 29.80±18.98 37.34±25.46 55.26±13.68
左心室 90.51±47.32 32.51±24.93 58.19±29.18 64.79±13.68
t值 -8.729 -1.924 -12.192 -10.936
P值 0.000 0.057 0.000 0.000
图4 健康人右心室舒张末期容积（RVEDV）与左心室舒张末期容积（LVEDV）的相关性
图5 健康人右心室每搏输出量（RVSV）与左心室每搏输出量（LVSV）的相关性
表4 健康人左心室与右心室功能参数的Pearson相关分析
检验值 EDV ESV SV EF
r值 0.215 0.178 0.201 0.167
P值 0.026 0.067 0.038 0.085
[1]
Meyer P,Filippatos GS,Ahmed MI, et al. Effects of right ventricular ejection fraction on outcomes in chronic systolic heart failure[J]. Circulation, 2010, 121(2): 252-258.
[2]
Larose E,Ganz P,Reynolds HG, et al. Right ventricular dysfunction assessed by cardiovascular magnetic resonance imaging predicts poor prognosis late after myocardial infarction[J]. J Am Coll Cardiol, 2007, 49(8): 855-862.
[3]
王玥,杨军,白洋. 单心动周期实时三维超声心动图评价房间隔缺损患者分流量[J]. 中国医学影像技术, 2011, 27(11): 2206-2209
[4]
武琼. 不同剂量的瑞舒伐他汀对急性心肌梗死患者的影响[D]. 青岛大学, 2014.
[5]
中华医学会心血管病学分会, 中华心血管病杂志编辑委员会. 右心衰竭诊断和治疗中国专家共识[J]. 中华心血管病杂志, 2012, 40(6): 449-461.
[6]
Liu YN,Deng YB,Liu BB, et al. Rapid and accurate quantification of right ventricular volume and stroke volume by real-time 3-dimensional triplane echocardiography[J]. Clin Cardiol, 2008, 31(8): 378-382.
[7]
Zhang QB,Sun JP,Gao RF, et al. Feasibility of single-beat full-volume capture real-time three-dimensional echocardiography for quantification of right ventricular volume: validation by cardiac magnetic resonance imaging[J]. Int J Cardiol, 2013, 168(4): 3991-3995.
[8]
梁蕾,闻志超,郭君,实时三维超声心动图与磁共振成像评价右心功能的对照研究[J]. 中国临床医学影像杂志, 2013, 24(7): 469-471.
[9]
Morikawa T,Murata M,Okuda S, et al. Quantitative analysis of right ventricular function in patients with pulmonary hypertension using three-dimensional echocardiography and a two-dimensional summation method compared to magnetic resonance imaging[J]. Am J Cardiol, 2011, 107(3): 484-489.
[10]
Shimada YJ,Shiota M,Siegel RJ, et al. Accuracy of right ventricular volumes and function determined by three-dimensional echocardiography in comparison with magnetic resonance imaging: a meta-analysis study[J]. J Am Soc Echocardiogr, 2010, 23(9): 943-953.
[11]
Jenkins C,Chan J,Bricknell K. et al. Reproducibility of right ventricular volumes and ejection fraction using real-time three-dimensional echocardiography: comparison with cardiac MRI[J]. Chest, 2007, 131(6): 1844-1851.
[12]
Bhave NM,Patel AR,Weinert L, et al. Three-dimensional modeling of the right ventricle from two-dimensional transthoracic echocardiographic images: utility of knowledge-based reconstruction in pulmonary arterial hypertension[J]. J Am Soc Echocardiogr, 2013, 26(8): 860-867.
[13]
van der Zwaan HB,Helbing WA,Boersma E, et al. Usefulness of real-time three-dimensional echocardiography to identify right ventricular dysfunction in patients with congenital heart disease[J]. Am J Cardiol, 2010, 106(6): 843-850.
[14]
Rudski LG,Lai WW,Afilalo J, et al. Guidelines for the echocardiographic assessment of the right heart in adults: a report from the American Society of Echocardiography endorsed by the European Association of Echocardiography, a registered branch of the European Society of Cardiology, and the Canadian Society of Echocardiography[J]. J Am Soc Echocardiogr, 2010, 23(7): 685-713.
[15]
陈立斌,尹凤英,张盛敏, 等. 超声心动图对正常成人右心结构及功能的评估[J/CD]. 中华医学超声杂志:电子版, 2013, 10(9): 718-725.
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