二维斑点追踪成像技术评价心尖肥厚型心肌病右房功能

Assessment of Right Atrial Function in Apical Hypertrophic Cardiomyopathy by Two-Dimensional Speckle Tracking Imaging

摘要: 目的：应用二维斑点追踪成像技术(2D-STI)评价心尖肥厚型心肌病患者(ApHCM)的右心功能。方法：选取28例ApHCM患者和45例年龄、性别相匹配的正常对照组，分析比较两组常规超声心动图参数和二维应变参数的差异。结果：与对照组比较，ApHCM组的收缩末期右房前后径(RAd)、右房最小容积(RAVmin)、右房收缩前容积(RAVpreA)、舒张末期室间隔厚度(IVSD)和舒张末期左室后壁厚度(LVPWD)均明显升高，而右房排空分数(RAEF)、三尖瓣环收缩期位移(TAPSE)、右室面积变化率(RVFAC)、三尖瓣环侧壁收缩速度(S’)、右室纵向总应变(RVGLS)、右室心尖段应变(RV apical strain)、右室中间段应变(RV mid-wall strain)、右室游离壁应变(RVFWS)、右房储备期应变(RASr)、右房通道期应变(RAScd)、右房收缩期应变(RASct)均明显减低，差异均具有统计学意义(P均 < 0.05)。其余参数两组之间的差异均无统计学意义(P均 > 0.05)。结论：2D-STI可以定量评估ApHCM患者右心功能障碍，为临床评估ApHCM患者的心肌损伤提供更多参考信息。

Abstract: Objective: To evaluated the structure and function of the right atrium(RA) in apical hypertrophic cardiomyopathy (ApHCM) were by using two-dimensional speckle tracking imaging technology (2D-STI). Methods: Twenty-eight patients with ApHCM and 45 normal controls matched by age and gender in the Second Affiliated Hospital of Anhui Medical University from January 2024 to April 2025 were selected and included in this study. The conventional echocardiographic parameters and two-dimensional strain parameters of the two groups were analyzed and compared. Results: Compared with the control group, the anterior and posterior diameters of the right atrium (RAd), the minimum volume of the right ventricle (RAVmin), the pre-systolic volume of the right atrium (RAVpreA), the thickness of the ventricular septum at the end of diastolic phase (IVSD), and the thickness of the posterior wall of the left ventricle at the end of diastolic phase (LVPWD) in the ApHCM group were all significantly increased. The right atrium emptying fraction (RAEF), the tricuspid annular plane systolic excursion (TAPSE), the right ventricular systolic displacement area change rate (RVFAC), Systolic velocity of tricuspid annulus (S’), right ventricular global longitudinal strain (RVGLS), right ventricular apical strain (RV apical strain), right ventricular middle wall strain (RV mid-wall strain), right ventricular free wall strain (RVFWS), right atrial strain during reservoir phase (RASr), right atrial strain during conduit phase (RAScd), and right atrial strain during contraction phase(RASct) were all significantly decreased, and the differences were statistically significant (all P < 0.05). There was no statistically significant difference in the remaining parameters between the two groups (all P > 0.05). Conclusion: 2D-STI can quantitatively evaluate right atrial dysfunction in patients with ApHCM, providing more reference information for the clinical assessment of myocardial injury in patients with ApHCM.