实时三维超声心动图定量评价心力衰竭患者左室收缩同步性的临床初步研究

Quantitative assessment of left ventricular systolic synchronicity in patients with heart failure by real-time three-dimensional echocardiography

目的探讨实时三维超声心动图定量评价心力衰竭患者左室收缩同步性的临床价值。方法心力衰竭患者18例,正常对照组20例。应用实时三维超声心动图Qlab技术描绘左室容量-时间曲线,计算左室16节段达最低收缩末容量时间的标准差(Tmsv16-SD)、最大差异(Tmsv16-Dif)及二者的标准化值[Tmsv16-SD/R-R(%)、Tmsv16-Dif/R-R(%)]。结果正常对照组左室容量-时间曲线各节段排列有序,起伏一致,达最低收缩末容量的时间点几乎在一条直线,而心力衰竭组左室容量-时间曲线各节段分布彼此交错,运动幅度平坦,达最低收缩末容量的时间点分散。心力衰竭组曲线参数Tmsv16-SD、Tmsv16-Dif、Tmsv16-SD/R-R(%)及Tmsv16-Dif/R-R(%)均明显大于正常对照组(P<0.01)。结论实时三维超声心动图左室容量-时间曲线形态及参数能全面反映左室收缩运动同步性及功能变化。

Objective To quantitatively assess left ventricular systolic synchronicity with heart failure（HF） by real-time three-dimensional echocardiography. Methods The study consisted of 18 patients with HF and 20 normal subjects for comparison. Real-time three-dimensional echocardiography volume-time curves （VTCs） were obtained by Qlab software. The time to minimal systolic volume of 16-segmental＇standard deviation （Tmsv16-SD）, maximal difference （Tmsv16-Dif）, Tmsv16-SD/R-R （%） and Tmsv16-Dif/R-R （%） were derived. Results The normal volume-time curves were regular pa- rabola and arrange in order. The volume-time curves were interlace with each other and Tmsv were significantly larger in HF group. Tmsv16-SD, Tmsv16-Dif, Tmsv16-SD/R-R （%） and Tmsv16-Dif/ R-R （%） were significantly different between the two groups （P〈0.01）. Conclusion The shape and parameters of VTCs can evalute left ventricular volume, function and systolic synchronization.