Objective Right ventricular (RV) function is an independent prognosis predictor in patients undergoing cardiac surgery. The objective of this study is to evaluate the feasibility of quantifying RV function by Two-dimensional speckle tracking imaging (2D-STI); and to assess the influence of LV function and the cardiac surgery on RV function. Methods 2D-ST1 was performed in 61 patients who undergone cardiac surgery and 25 healthy subjects (Control group). The imaging was analyzed offline with Qlad 6. 0 TMQA to determine the longitudinal RV peak systolic strain (e) and the peak systolic velocity (S) of the 3 segments of RV free wall. The RV functional parameters were compared between patients with preserved LVEF (LVEF>50%) and with decreased LVEF (LVEF<50%), Meanwhile, the postoperative change of RV function was monitored 1 week, 3 months and six months after the surgery, and was compared with the pre-operative data. Results Patients with decreased LVEF had lower RV systolic peak strain and velocity, as compared both with preserved LVEF group (P<0.05) and with control group (P< 0. 05). There were no differences of RV functional parameters between the patients with preserved LVEF and the controls. Both in CPB group (n=33) and in OP group (n=28), RV systolic peak strain and velocity were decreased significantly 1 week after surgery as compared with those preoperative; and then recovered 3 and 6 months after surgery, with no difference when comparing with preoperative data and with those of control group. Conclusions 2D-ST1 could be a promising technique to quantify and monitor RV function noninvasively. The longitudinal systolic peak strain of free wall would be used as RV functional parameters. Patients with abnormal LVEF had damaged RV deformation and motion function. No matter under which pattern of circulation, cardiac surgery could do harm to RV function transiently; the reversible injury would be recovered in about 3 months after the surgery.%目的 右心室功能对各类心脏手术的预后有重要的预测价值.本研究运用二维斑点追踪技术对心脏手术患者围手术期右室功能进行定量分析,探讨左心室功能及心脏手术对于右心室功能的影响.方法 对因冠心病、瓣膜疾病或先天性心脏病在华山医院心胸外科行手术治疗者61例进行右心室图像的采集和随访；另选取25例正常人作为对照组.使用Qlab 6.0 TMQA软件测量右心室游离壁基底段、中间段及心尖段的收缩期纵向峰值应变(ε)和纵向峰值运动速度(S)；比较术前左心室功能不同的患者右心室指标的差异,对心脏手术前后患者的右心室功能改变进行随访.结果 术前左室射血分数(LVEF)下降组(LVEF＜50％)与对照组及射血分数(EF)正常组(LVEF≥50％)相比,右心室游离壁各节段的收缩期纵向峰值应变及速度均明显下降(P均＜0.05).不论是体外循环组(CPB组)还是非体外循环组(OP组),术后1周其右心室游离壁各节段的变形及运动功能均出现一过性降低,术后3个月和6个月恢复.结论 左心室功能异常可伴有右心室变形和运动能力下降；无论体外循环还是非体外循环,心脏手术后早期会出现一过性右心室功能损伤.二维斑点追踪技术为无创定量评价右心室功能提供了有效的手段,测量右心室游离壁收缩期纵向峰值应变可用于监测及随访心脏手术患者围手术期的RV功能,有助于危重患者的识别、预后评估和临床决策.
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