左室壁运动同步性的实时三维超声心动图定量研究

Study of quantifying left intraventricular synchronism using real-time three-dimensional echocardiography

目的应用实时三维超声心动图(RT-3DE)定量评价正常人及心力衰竭患者左室壁运动的同步性。方法采用实时三维超声心动图技术检测24例正常人、16例扩张型心肌病及27例心肌梗死患者左室壁各节段达舒张期最大容积时间以及收缩期最大射血分数时间。结果心肌梗死组与正常组的左室壁从第一个节段达舒张期最大容积到最后一个节段达舒张期最大容积的时相段在一个心动周期中分别占(12.42±4.47)%和(7.34±2.26)%,心肌梗死组较正常组显著延长(P<0.05);扩张型心肌病组与正常组的左室壁从第一个节段达最大射血分数到最后一个节段达最大射血分数的时相段在一个心动周期中分别为(17.20±6.48)%和(6.11±1.49)%,扩张型心肌病组与正常组相比差异有显著性(P<0.05)。结论左室壁各节段达舒张期最大容积及达收缩期最大射血分数并非在一个时间点,而是在一个时间段内,有先后之分;心肌梗死患者和扩张型心肌病患者该时间段延长,室壁运动的同步性下降。

Objective To evaluate left intraventricular synchronism of the normals and the patients with heart failure using real-time three-dimensional echocardiography（ RT-3DE）. Methods RT-3DE was performed in 24 normals, 16 patients with dilated cardiomyopathy and 27 with myocardial infarction. The parameters were measured off line in left ventricular 16 segments, including the time of achieving diastolic maximum volume and the time of achieving maximum ejection fraction. Results In the normals, it took a period of 7.34% ± 2.26% of one cardiac cycle from the first segment achieving maximum volume to the last segment achieving maximum volume, but in MI patients, it lasted a period of 12.42% ± 4.47% of one cardiac cycle. From the first segment achieving maximum ejection fraction to the last segment achieving maximum ejection fraction, it lasted a period of6.11% ± 1.49% in the normals, and in DCM patients, it took a period of 17.20 % ± 6.48 % of one cardiac cycle. Conclusion Regional volume and regional ejection fraction curves indicate that it is not at the same time when every left ventricular wall segments achieved the largest volume and the great ejection fraction. In the patients with DCM and MI, left ventricular synchronization descend.