摘要目的 探讨经食管实时三维超声心动图(real time three dimensional transesophageal echocardiography,RT 3D-TEE)测量轻度二尖瓣反流(mitral regurgitation,MR)患者二尖瓣瓣叶和瓣环参数在二尖瓣反流机制中的作用.方法 对57例MR患者和28例无二尖瓣反流的对照组,分别行RT-3D-TEE检查,应用MVQ(mitral valve quantification)软件进行后处理,测量收缩末期前后叶闭合时瓣环参数:高度与联合直径比(H/DAIPm)、椭圆度(E2D)、主动脉瓣环与二尖瓣环平面夹角(θAv-Mv)、瓣环非平面角度(瓣环θnpa)；瓣叶参数:小叶穹隆面积(A3DE)、投影平面中的对合长度( L2DAIPm)、瓣叶A1-A3区穹隆体积(VA1-3tent)、瓣叶P1-P3区穹隆体积(VP1-3tent)、瓣叶穹隆容积(Vtent)、瓣叶穹隆高度(Htent)、瓣叶非平面角度(瓣叶θnpa).比较两组结果,筛检出能够揭示MR机制的参数.结果 MR组:瓣环θnpa和L2DAIPm均较对照组增大,VA3tent较对照组减小,瓣叶θnpa与MR独立相关.结论 轻度二尖瓣反流组瓣环几何形态趋于平面化,瓣叶局部向瓣环方向的运动增强,瓣叶θnpa与轻度二尖瓣反流独立相关.

abstractsObjective To measure the parameters of mitral valve leaflets and mitral annulus in patients with mild mitral regurgitation ( MR ) by real time three-dimensional transesophageal echocardiography (RT-3D-TEE),and explored the mechanism of MR.Methods Fifty-seven MR subjects were selected and twenty-eight subjects without mitral regurgitation were served as control group,all subjects were examined by RT-3D-TEE and acquired image,mitral valve quantification (MVQ) software was used for post-processing.Mitral annulus parameters (H/DAIPm,E2D,θAv-Mv,mitral annulus θnpa) and mitral valve leaflets parameters(A3DE,L2DAIPm,VA1-3tent Vp1-3tent Vtent Htent θnpa ) at the end of systolic were measured.The results of two groups were compared,and the most affected parameters to mild mitralregurgitation were selected.Results Compared with control group,VA3tent was decreased,mitral annulus θnpa and L2DAIPm increased,and the mitral valve leaflets θnpa was independently correlation factor of mild mitral regurgitation.Conclusions The mitral annulus geometry to flat in subjects with mild MR,the mitral valve local area is increased in subjects with mild MR,the mitral valve leaflets θnpa is independently correlation factor of mild mitral regurgitation.