| 摘要: |
| 【】目的:应用经胸三维超声心动图定量评估房性与室性功能性二尖瓣反流患者的二尖瓣构型。方法:选择在三峡大学第一临床医学院心血管内科就诊的室性功能性二尖瓣反流患者68例作为VFMR组,房性功能性二尖瓣反流患者53例作为AFMR组。同时期另选50例相同年龄水平健康志愿者作为对照组。应用经胸三维超声心动图定量获取二尖瓣相关参数:瓣环前后径(AP)、瓣环前外-后内侧直径(ALPM)、瓣环高度(AH)、瓣环周长(CD)、瓣环面积(AA)、瓣环非平面角度(NPA)、前小叶面积(ALA)、后小叶面积(PLA)、小叶总面积(TLA)、帐篷容积(VTent)、帐篷高度(HTent)、后小叶角度(PLθ),比较上述参数在各组间差异有无统计学意义。结果:与对照组相比,AFMR组与VFMR组AP、ALPM、AP/ALPM、AH、CD、AA、NPA、ALA、PLA、TLA、PLθ均较大,TLA/AA较小,AFMR组VTent、HTent较小,而VFMR组VTent、HTent较大,差异均具有统计学意义(P<0.05)；VFMR组AP、ALPM、AP/ALPM、ALA、PLA、TLA、VTent、HTent、TLA/AA大于AFMR组,PLθ小于AFMR组,差异具有统计学差异(P<0.05)。结论:二尖瓣瓣环扩张、扁平化及瓣叶代偿性增大是功能性二尖瓣反流的常见变化。与AFMR相比,VFMR二尖瓣瓣环形态更圆、瓣叶及小叶帐篷增大更显著,而后小叶栓系则不明显。经胸三维超声心动图可以无创定量评价房性与室性功能性二尖瓣反流患者二尖瓣构型,为临床决策提供一定的依据。 |
| 关键词: 三维超声心动图 功能性二尖瓣反流 二尖瓣构型 小叶栓系 |
| DOI： |
| 投稿时间：2024-01-21修订日期：2024-04-16 |
| 基金项目: |
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| Clinical Study on the Mitral Valve Configuration in Patients with Atrial and Ventricular Functional Mitral Regurgitation |
| HU Wenshu,ZHOU Chang,NIE Shuting,SHAO Yuanyuan,LI Xinyi |
| (Department of Ultrasound,Yichang Central People''s Hosptial,The First College of Clinical Medical Science,China Three Gorges University) |
| Abstract: |
| 【】Purpose? This study aimed to employ transthoracic three-dimensional echocardiography for the quantitative evaluation of mitral valve configuration in patients with atrial and ventricular functional mitral regurgitation . Methods? A cohort of 68 VFMR patients and 53 AFMR patients, diagnosed at the Department of Cardiovascular Medicine, the First Clinical Medical College of Three Gorges University, constituted the VFMR and AFMR groups. Additionally, 50 age-matched healthy volunteers were included as the control group. Mitral valve parameters, including anterior-posterior diameter (AP), anterior leaflet-to-posterior leaflet diameter (ALPM), annular height (AH), annular circumference (CD), annular area (AA), non-planar angle (NPA), anterior leaflet area (ALA), posterior leaflet area (PLA), total leaflet area (TLA), tenting volume (VTent), tenting height (HTent), and posterior leaflet angle (PLθ), were quantitatively assessed using transthoracic real-time three-dimensional echocardiography. Statistical analysis was performed to assess the significance of differences in these parameters among the groups. Results In comparison to the control group, both AFMR and VFMR groups exhibited significantly increased values in AP, ALPM, AP/ALPM, AH, CD, AA, NPA, ALA, PLA, TLA, and PLθ, with a decreased TLA/AA ratio observed in the AFMR group. The VFMR group demonstrated smaller VTent and HTent, while the AFMR group showed larger VTent and HTent, all demonstrating statistical significance (P < 0.05). VFMR group values for AP, ALPM, AP/ALPM, ALA, PLA, TLA, VTent, HTent, and TLA/AA were greater than those of the AFMR group, while PLθ was smaller in the VFMR group, all with statistical significance (P < 0.05). Conclusion Mitral annular dilation, flattening, and compensatory leaflet enlargement were identified as common alterations in functional mitral regurgitation. In comparison to AFMR, VFMR presented with a more circular mitral annular shape, more pronounced leaflet and chordal tenting enlargement, with less prominent posterior leaflet tethering. The application of transthoracic real-time three-dimensional echocardiography enables non-invasive and quantitative assessment of mitral valve configuration in patients with atrial and ventricular functional mitral regurgitation, providing valuable insights for clinical decision-making. |
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