实时三维超声心动图定量评价二尖瓣脱垂患者的二尖瓣几何结构

摘要

Objective To investigate the effect of mitral valve prolapse(MVP) on the structure and function of the valve leaflet and valve annulus by quantitative analysis of mitral geometry with real-time 3D transthoracic echocardiography (RT-3D TTE).Methods RT-3D TTE was performed in 30 normal controls and 30 patients with MVP.Various measurements of mitral valve leaflet and annulus were obtained using mitral valve assessment software.Results The AP diameter,AL-PM diameter,annulus circumference,annulus area,annulus height,commissural diameter,anterior leaflet area,posterior leaflet area,anterior leaflet length and posterior leaflet length in MVP team were larger than those in the controls (P＜0.05).Posterior length angle in MVP team were smaller than those in the controls (P＜0.05).But there were no significance in sphericity index,non-planar angle,tenting height,tenting volume,tenting area,a displacement(max),annular displacement velocity(max) and annular area fraction (2D) between the two groups.Conclusions MVP can lead to a certain change in the geometric structure of the valve annulus and the valve leaf,but it has little effect on the dynamic deformation of the valve annulus.%目的 应用经胸实时三维超声心动图定量分析二尖瓣几何结构,探讨二尖瓣脱垂对患者瓣叶及瓣环结构和功能的影响.方法 对30例二尖瓣脱垂患者(脱垂组)及30例正常人(对照组)分别行经胸实时三维超声心动图检查,并使用MVA后处理软件脱机分析二尖瓣环及瓣叶的各个参数.结果 脱垂组瓣环前后径、前外后内径、周长、面积、高度、连合处直径、前叶面积、后叶面积、前叶长度、后叶长度明显大于对照组,后叶角度明显小于对照组,球度指数、非平面角度、幕状区高度、幕状区容积、幕状区面积、瓣环最大位移、瓣环位移最大速率、瓣环面积分数与对照组比较无明显差异.结论 二尖瓣脱垂可导致患者瓣环及瓣叶的几何结构发生一定变化,但对瓣环的动态形变功能影响较小.