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目的应用二维斑点追踪显像(2D speckle tracking echocardiography,2DSTE)技术探讨正常人左心房(LA)与右心房(RA)功能的差异性。方法正常人148名,获取心尖四腔观和二腔观图像,应用Tom Tec软件脱机分析心房应变及应变率参数:反映心房储存功能的收缩期整体纵向峰值应变εs、反映心房管道功能的舒张早期心房整体纵向峰值应变εe、反映心房泵功能的舒张晚期心房整体纵向峰值应变εa,以及对应时相的应变率参数SRs、SRe、SRa。结果 LA最大容积(43±11)ml、储存功能参数[充盈总容积(30±9)ml,扩张指数(193±92)%,舒张期排空指数(63±11)%]和通道功能参数[被动排空指数(30±10)%]均显著高于RA上述指标[分别为(38±10)ml、(21±7)ml、(138±79)%、(54±12)%和(25±13)%],均P<0.01。而与之相反的是,应变分析结果显示RAεs(59±8)%,SRs(2.5±0.7)/s,εe(32±10)%和εa(-29±11)%均显著高于LAεs(43±6)%,SRs(2.3±0.7)/s,εe(23±5)%和εa(-20±3)%,均P<0.01。结论应用2DSTE技术测得正常人LA和RA的功能存在差异性。
Objective To investigate the difference of function between left atrium (LA) and right atrium (RA) by 2D speckle tracking echocardiography (2DSTE). Methods A total of 148 normal subjects were enrolled in this study. The atrial and ventricular responses were measured offline using Tom Tec software. The longitudinal peak strain εs of the systolic period, which reflects atrial storage function, The longitudinal peak strain εe of the whole early atrium, the longitudinal peak strain εa of the atrial end-diastolic atrium reflecting the atrial pump function, and the strain rate parameters SRs, SRe and SRa of the corresponding phase. Results The maximal volume of LA was (43 ± 11) ml, the parameters of storage function [total volume of filling (30 ± 9) ml, index of expansion (193 ± 92)%, index of diastolic expulsion (63 ± 11)%] [Passive emptying index (30 ± 10)%] were significantly higher than those of RA [38 ± 10 ml, 21 ± 7 ml, 138 ± 79%, 54 ± 12% and (25 ± 13)%], all P <0.01. In contrast, strain analysis showed that RAεs (59 ± 8)%, SRs (2.5 ± 0.7) / s, εe (32 ± 10)% and εa (-29 ± 11)% were significantly higher than those of LAεs 43 ± 6%, SRs 2.3 ± 0.7 / s, εe 23 ± 5% and εa -20 ± 3%, both P <0.01. Conclusion 2DSTE technique is used to measure the difference of function of LA and RA in normal subjects.