三维超声心动图测量心肌梗塞左室心肌重量的实验研究

Experimental Study of Three dimensional Echocardiography in Quantifying Left Ventricular Mass after Myocardial Infarction

左室心肌重量（ＬＶＭ）的准确测量对高血压病等疾病的预后判断及疗效评价具有重要意义。Ｍ－型超声及二维超声心动图方法因形状假设等限制性使其测量ＬＶＭ的准确性受到影响。本研究采用多平面经食管三维超声心动图，在冠状动脉结扎前后分别测量了１９只实验犬的在体心脏左室心肌重量，并与左室心肌重量的实测值进行了对照。结果显示，冠状动脉结扎前后，三维超声心动图的ＬＶＭ测值均与其实测值高度相关（ｒ分别为０．９５，０．９６；ＳＥＥ＝２．２ｇ，２．１ｇ）。结论认为，多平面经食管三维超声心动图在冠状动脉结扎前后均可准确测量ＬＶＭ，为临床定量评价左室肥厚提供了新的准确方法，尤其在高血压合并冠心病患者具有重要价值。

Accurate left ventricular mass(LVM)determination is crucial to judgement of prognosis and curative effects in patients with hypertension and valvular disease.The reliability of currently used M mode and 2 D echocardiographic methods were limited because they must adopt geometric assumptions that may be incorrect in many clinical instances.The purpose of this study was to validate the availibility and reliability of multiplane transesophageal three dimensional echocardiography(3DE) in quantitative estimation of LVM both in normal hearts and those with overt ventricular wall motion abnormalities.The LVM of 19 beating canine heart were reconstructed by 3DE before and after coronary artery ligation respectively.The results were compared to the actual weight of left ventricle.It showed that the measurements of 3DE correlated highly with the actual values both before and after coronary artery ligation(r=0 95,0 96;SEE=2 2g,2 1g respectively).It was concluded that multiplane transesophageal three dimensional echocardiography could accurately measure LVM both in normal hearts and those with ventricular wall motion abnormalities,therefore provide a new method for quantitative diagnosis of left ventricular hypertrophy.