实时三维超声心动图容积-时间曲线评价左心室舒张功能的初步研究

Preliminary clinical study of real-time three-dimensional echocardiography volume-time curve in evaluating left ventricular diastolic function

目的利用实时三维超声心动图容积时间曲线评价左室舒张功能正常及异常患者的曲线变化情况。方法以频谱组织多普勒二尖瓣环舒张早期速度<二尖瓣环舒张晚期速度为左室舒张功能减低的诊断标准,取24例单纯左室舒张功能减低的患者(分为松弛延迟组及假性正常化组,各12例)和24例健康志愿者,进行实时三维超声心动图全容积采集,并进行容积时间曲线分析,比较三组实时三维超声心动图参数:左室舒张末容积(EDV)、左室收缩末容积(ESV)、左室射血分数(LVEF)、左室最大射血速率(PER)、左室最大充盈速率(PFR)之间的差异。结果与正常对照组相比,松弛功能延迟组及假性正常化组的实时三维超声心动图舒张充盈参数PRF明显降低(P<0.05),其他指标EDV、ESV、LVEF、PER无明显差异(P>0.05)。结论实时三维超声心动图容积时间曲线参数PFR可以评估早期左室舒张功能减低,为临床评价左室舒张功能提供了一个无创、快速、准确的新手段。

Objective To evaluate volume-time curve change in patients with normal left ventricular （LV） diastolic function and diastolic dysfunction by real-time three-dimensional echocardiography （RT3DE）. Methods LV diastolic dysfunction was defined by mitral annulus early diastolic velocity^mitral annulus late diastolic velocity. In 24 patients with single LV diastolic dysfunction（delayed relaxation group and pseudo normal group, n = 12 respectively） and 24 normal control volunteers full-volume image data acquired by RT3DE underwent volume-time curve analysis. End diastolic volume （EDV）, end-systolic volume（ESV） ,left ventricular ejection fraction （LVEF） , peak ejection rate （PER） , peak filling rate （PFR） from RT3DE were investigated in three groups. Results Compared to normal control group, PFR was reduced significantly in delayed relaxation group and pseudo-normal group（ P d0. 05） ~ while there were no significant difference in EDV,ESV,LVEF,PER（ P P〉0. 05）. Conclusions PFR as a diastolic filling index of RT3DE can evaluate early diastolic dysfunction and provide a new non invasive,prompt and accurate tool for clinical LV diastolic function evaluation.