摘要
目的:探讨动脉导管未闭介入封堵所致的急性左心室前负荷降低对二尖瓣环运动的影响。方法:选择60例行经导管介入封堵的单纯性动脉导管未闭(PDA)患儿作为研究对象,术前72h内、术后24h进行常规的心脏超声及组织多普勒(TDI)超声检查。结果:所有PDA患儿介入封堵成功,与术前相比,术后24h左室舒张末期内径(LVEDD)、左室收缩末期内径(LVESD)、跨二尖瓣口血流速度参数E峰、A峰数值均显著降低(P<0.01);二尖瓣环左室侧壁E峰TDI速度E_(mL)(P<0.01)、A峰TDI速度A_(mL)(P<0.01)显著降低,收缩波S峰值速度S_(mL)虽有降低,但差异无统计学意义,E_(mL)/A_(mL)比值无显著变化;二尖瓣环室间隔侧S_(mT)、E_(mT)显著下降(均P<0.01),而术前、后A_(mT)、E_(mT)/A_(mT)比值比较差异无统计学意义。二尖瓣环两侧S_m、E_m的降低与前负荷降低的程度dDD呈直线相关,E_m最显著。结论:介入术后24h,左心室前负荷急性降低,TDI测定的二尖瓣环的收缩期、舒张期运动速度亦降低,影响程度与前负荷改变程度呈正相关,左室侧壁二尖瓣环组织所受影响相对较小,E_m随前负荷变化改变最显著。
Objective：To exploreeffects of acute decrease in preload onmitral annulus movement of left ventricular（LV）after interventional operation of patent ductus arteriosus（PDA）.Method：Sixty children with patent ductus arteriosus（PDA）only who underwent transcatheter closure were selected as the subjects.Routine echocardiography and Tissue Doppler imaging（TDI）were performed within 72 hours before operation and 24 hours after operation.Result：All operations were successful for the PDA children.Compared with preoperation,left ventricular end diastolic diameter（LVEDD）and left ventricular end systolic diameter（LVESD）were decreased.Peak early diastolic（E）and peak late diastolic（A）velocities of transmitral blood flow were also decreased significantly within 24 hours after operation.For the left ventricle（LV）,early diastolic TDI velocities（EmL）and late diastolic TDI velocities（AmL）on the lateral side of the mitral annulus were decreased significantly after operation（P〈0.001）.Peak systolic velocities（SmL）were also decreased but with no significance.Differently,EmT and SmTon the septal side of mitral annulus were decreased significantly.No significant changes were seen in the ratio of Em/Amonboth sides.The variance of Em and Sm suggested a greater resistance of the left ventricular diameter（dDD）,especially for Em,on both side of mitral annulus.Conclusion：Both systolic and diastolic TDI velocities of the mitral annulus are preload-dependent and may decrease as an acute reduction of LV preload,while the lateral mitral annulus less resistant.Peakvelocities of early diastolic TDI（Em）was most significant in the change.
作者
唐颖
朱善良
陈俊
秦玉明
杨世伟
花立春
TANG Ying;ZHU Shanliang;CHEN Jun;QIN Yuming;YANG Shiwei;HUA Lichun(Department of Ultrasound, Children＇s Hospital of Nanjing Medical University, Nanjing, 210008, China;Department of Cardiology,Children＇s Hospital of Nanjing Medical University)
出处
《临床心血管病杂志》
CAS
CSCD
北大核心
2018年第6期597-601,共5页
Journal of Clinical Cardiology
基金
南京医科大学科技发展基金面上项目(No:2015NJMU067)
南京市医学科技发展基金资助(No:QRX17171)
关键词
动脉导管未闭
组织多普勒
前负荷
介入治疗
patent ductus arteriosus
tissue doppler imaging
preload
interventional therapy
