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目的应用经食管实时三维超声心动图(RT-3DTEE)分析二尖瓣脱垂(MVP)患者不同程度反流瓣环立体结构在全心动周期的变化规律。方法57例行RT-3DTEE检查的患者,对照组33例,MVP患者24例,其中14例为二尖瓣中-重度反流组,10例为二尖瓣轻度反流组。应用QLab 7.0软件分别于舒张早、中、晚期和收缩早、中、晚期测量二尖瓣瓣环。结果与对照组相比,轻度MR组DAP于收缩中晚期、舒张早期、舒张晚期增大(P<0.05);中-重度MR组于全心动周期瓣环C3D、A2D、DAP、DAlPm均明显增大(P<0.05)。与轻度MR组相比,中-重度MR组DAP于全心动周期均明显增大,A2D、C3D、DAlPm于收缩晚期、舒张中期增大(P<0.05),而H、H/DAlPm差异均无统计学意义(P>0.05)。结论不同程度MR瓣环结构变化不同,瓣环前后径扩大比前外后内径出现较早。
Objective To analyze the changes of three-dimensional structure of the regurgitant valve annulus in patients with mitral valve prolapse (MVP) during the whole cardiac cycle using transesophageal real-time three-dimensional echocardiography (RT-3DTEE) Methods Fifty-seven patients underwent RT-3DTEE, 33 in control group and 24 in MVP group. Among them, 14 were mitral-moderate-severe regurgitation and 10 were mitral-mild regurgitation. Mitral annulus was measured by QLab 7.0 software in early, middle and late diastole and early, middle and late diastole respectively. Results Compared with the control group, the DAP in mild MR group was significantly higher in the middle and advanced stages of contractions, earlier in diastole and later in diastole (P <0.05), while in C3D, A2D, DAP and DAlPm in the MR group Increased (P <0.05). Compared with mild MR group, the DAP of all the patients in moderate-severe MR group was significantly increased during the whole cardiac cycle. The levels of A2D, C3D and DAlPm in late stage of contraction and mid-diastole were increased (P <0.05), while those of H, H / DAlPm No statistical significance (P> 0.05). Conclusions The changes of the annulus structure of MR are different with different degrees. The anteroposterior diameter of annulus enlarges earlier than the anteroposterior diameter.