摘要: |
目的 应用实时三维超声心动图(RT-3DE)观察二尖瓣冗长瓣膜立体形态及左室流出道血流动力学改变,分析二尖瓣前叶冗长致左室流出道动力性梗阻的原因。方法 2018年2月至2020年3月本院经超声心动图确诊二尖瓣冗长患者18例(研究组),正常人23例(对照组)。在常规二维超声心动图基础上,应用RT-3DE观察畸形二尖瓣立体形态及血流动力学改变,测量两组的二尖瓣前叶长度(AMV-L)、左室流出道血流速度(LVOT-V)、压力阶差(LVOT-P)、室间隔厚度(IVS-D)、左室后壁厚度(LVPW-D)、左室舒张末期内径(LVD-D)、左室收缩末期内径(LVS-D)、二尖瓣血流速度(MV)、左室射血分数(LVEF)及心率(HR),测量研究组的二尖瓣前叶残余冗长部长度(AMV-eL)。结果 ①研究组的AMV-L、LVOT-V、LVOT-P、IVS-D、LVPW-D均大于对照组(P<0.05),而两组的LVD-D、LVS-D、MV、LVEF、HR均无显著性差异(P>0.05);②研究组二尖瓣前叶冗长部均出现收缩期前向运动(SAM);③研究组的AMV-L与AMV-eL呈正相关性(r=0.925,P<0.05),AMV-eL与LVOT-V、LVOT-P呈正相关性(r1=0.916,r2=0.923,P<0.05)。结论 二尖瓣冗长可致左室流出道梗阻,其残余冗长部收缩期前向运动是导致左室流出道梗阻的原因,梗阻程度取决于二尖瓣前叶长度及其残余冗长部长度。 |
关键词: 二尖瓣冗长 左室流出道梗阻 实时三维超声心动图 |
DOI: |
投稿时间:2020-05-13修订日期:2020-11-23 |
基金项目: |
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Analysis of left ventricular outflow tract obstruction due to mitral valve elongation by real-time three-dimensional echocardiographyHUANG Zhi-yong, WU Jie-ying, LUO Wei-quan, WU Hao-tang, WU Han-hui.(Department of Medical Ultrasound, Hospital of Traditional Chinese Medicine of Zhongshan, Guangdong,528400, China) |
huang zhiyong |
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Abstract: |
Objective Real time three-dimensional echocardiography (RT-3DE) was used to observe the three-dimensional shape of mitral valve elongation and the hemodynamic changes of the left ventricular outflow tract, and to analyze the causes of left ventricular outflow tract dynamic obstruction caused by anterior mitral valve elongation. Methods From February 2018 to March 2020, 18 patients with mitral valve elongation (Study Group) and 23 normal people (control group) were diagnosed by echocardiography in our hospital. On the basis of conventional two-dimensional echocardiography, RT-3DE was used to observe the three-dimensional shape and hemodynamic changes of malformed mitral valve. The length of anterior mitral valve (AMV-L), left ventricular outflow velocity (LVOT-V), pressure gradient (LVOT-P), interventricular septal thickness (IVS-D), left ventricular posterior wall thickness (LVPW-D), left ventricular end diastolic diameter (LVD-D), left ventricular end systolic diameter (LVS-D), mitral velocity (MV), left ventricular ejection fraction (LVEF) and heart rate (HR) were measured in the two groups. The Length of residual part of anterior mitral valve elongation (AMV-eL) was measured in the study group. Results ①The AMV-L, LVOT-V, LVOT-P, IVS-D and LVPW-D in the study group were higher than those in the control group (P < 0.05), but there was no significant difference in LVD-D, LVS-D, MV, LVEF and HR between the two groups (P > 0.05). ②The systolic anterior motion (SAM) of anterior mitral valve elongation was found in the study group. ③There was a positive correlation between AMV-L and AMV-eL in the study group (r=0.925,P<0.05), and between AMV-eL and LVOT-V, LVOT-P (r1=0.916,r2=0.923,P<0.05). Conclusion Mitral valve elongation can lead to left ventricular outflow tract obstruction. The SAM of anterior mitral valve elongation is the cause of left ventricular outflow tract obstruction. The degree of obstruction depends on the AMV-L and AMV-eL. |
Key words: Mitral valve elongation left ventricular outflow tract obstruction real-time three-dimensional echocardiography |