CAJ | 학술논문

目的：采用单心动周期三维超声评价房间隔缺损（ASD）患者封堵术前后右室容积和功能变化。方法2011年7月-2013年10月对45例单纯继发孔型ADS患者行介入封堵术。将患者分为ASD无肺动脉高压组28例和ASD合并肺动脉高压组17例。应用单心动周期三维超声结合术中右心导管检查测定两组患者封堵术前后的右室舒张末容积（RVEDV）、右室收缩末容积（RVESV）、右室每搏量（RVSV）、右室射血分数（RVEF）、肺动脉收缩压（PASP）和肺动脉平均压（mPAP），并计算右室心输出量（RVCO）。结果术后两组患者的RVEDV、RVESV、RVSV及RVCO均显著减低，与术前相比差异均有统计学意义（P＜0.05）。无肺动脉高压组的RVEF低于术前（P＜0.05），而伴肺动脉高压组与术前比较差异无统计学意义（P＞0.05）。术后伴肺动脉高压组的肺动脉压明显减低（P＜0.05）。结论单心动周期三维超声能快速、准确评估右室容积和功能；ASD患者封堵术后右室容积减低；无肺动脉高压患者封堵术后右室功能减低；伴肺动脉高压患者封堵术后肺动脉压降低而右室功能无明显变化。
목적：채용단심동주기삼유초성평개방간격결손（ASD）환자봉도술전후우실용적화공능변화。방법2011년7월-2013년10월대45례단순계발공형ADS환자행개입봉도술。장환자분위ASD무폐동맥고압조28례화ASD합병폐동맥고압조17례。응용단심동주기삼유초성결합술중우심도관검사측정량조환자봉도술전후적우실서장말용적（RVEDV）、우실수축말용적（RVESV）、우실매박량（RVSV）、우실사혈분수（RVEF）、폐동맥수축압（PASP）화폐동맥평균압（mPAP），병계산우실심수출량（RVCO）。결과술후량조환자적RVEDV、RVESV、RVSV급RVCO균현저감저，여술전상비차이균유통계학의의（P＜0.05）。무폐동맥고압조적RVEF저우술전（P＜0.05），이반폐동맥고압조여술전비교차이무통계학의의（P＞0.05）。술후반폐동맥고압조적폐동맥압명현감저（P＜0.05）。결론단심동주기삼유초성능쾌속、준학평고우실용적화공능；ASD환자봉도술후우실용적감저；무폐동맥고압환자봉도술후우실공능감저；반폐동맥고압환자봉도술후폐동맥압강저이우실공능무명현변화。
Objective To evaluate the changes of right ventricular (RV) volume and function by using single beat real-time three dimensional (3-D) echocardiography in patients with atrial septal defect (ASD) before and after percutaneous closure. Methods During the period from July 2011 to Oct. 2013, a total of 45 patients with pure ostium secundum defect were admitted to authors’ hospital to receive percutaneous transcatheter closer. The patients were divided into ASD without pulmonary hypertension (PH) group (group A, n = 28) and ASD with PH group (group B, n = 17). By using 3-D echocardiography and right cardiac catheterization, the right ventricular end-diastolic volume (RVEDV), right ventricular end-systolic volume (RVESV), right ventricular stroke volume (RVSV), right ventricular ejection fraction (RVEF), right ventricular cardiac output (RVCO), pulmonary artery systolic pressure (PASP) and the mean pulmonary artery pressure (mPAP) were determined before and after the percutaneous transcatheter closer. The results were compared between the two groups. Results After the treatment a statistically significant reduction in RVEDV, RVESV, RVSV and RVCO were seen in all patients (P < 0.05). In group A, RVEF decreased significantly after ASD closure when compared with that determined before transcatheter closer (P < 0.05), while no significant reduction in RVEF was seen in group B (P > 0.05). Pulmonary artery pressure (PAP) decreased significantly in group B after ASD closure when compared with that obtained before Objective To evaluate the changes of right ventricular (RV) volume and function by using single beat real-time three dimensional (3-D) echocardiography in patients with atrial septal defect (ASD) before and after percutaneous closure. Methods During the period from July 2011 to Oct. 2013, a total of 45 patients with pure ostium secundum defect were admitted to authors’ hospital to receive percutaneous transcatheter closer. The patients were divided into ASD without pulmonary hypertension (PH) group (group A, n = 28) and ASD with PH group (group B, n = 17). By using 3-D echocardiography and right cardiac catheterization, the right ventricular end-diastolic volume (RVEDV), right ventricular end-systolic volume (RVESV), right ventricular stroke volume (RVSV), right ventricular ejection fraction (RVEF), right ventricular cardiac output (RVCO), pulmonary artery systolic pressure (PASP) and the mean pulmonary artery pressure (mPAP) were determined before and after the percutaneous transcatheter closer. The results were compared between the two groups. Results After the treatment a statistically significant reduction in RVEDV, RVESV, RVSV and RVCO were seen in all patients (P < 0.05). In group A, RVEF decreased significantly after ASD closure when compared with that determined before transcatheter closer (P < 0.05), while no significant reduction in RVEF was seen in group B (P > 0.05). Pulmonary artery pressure (PAP) decreased significantly in group B after ASD closure when compared with that obtained before transcatheter closer (P < 0.05). Conclusion Single beat real-time 3-D echocardiography is a newly-developed technique. This technique can quickly and accurately assess the right ventricular volume and function. Right ventricular volume will decrease after ASD closer. In ASD patients without PH the right ventricular function will decrease after ASD closer, while in ASD patients with PH the right ventricular function shows no changes after ASD closer although their PAP will decrease.