实时三维超声心动图容积时间曲线评价左心室整体收缩和舒张功能

Assessment of left ventricular global systolic and diastolic function using volume-time curves by real-time threedimensional echocardiography

目的应用实时三维超声心动图（RT-3DE）容积-时间曲线（VTC）定量评价左心室整体收缩和舒张功能。方法98例研究对象分为4组：A组，正常人28例；B组，高血压病患者24例；C组，冠心病患者24例；D组，扩张性心肌病22例。对所有研究对象进行RT-3DE检查，采集全容积三维图像，应用Qlab分析软件对三维数据库进行分析，得到左室整体和17节段容积时间曲线，测量舒张末容积（EDV）、收缩末容积（EsV）和左室射血分数（EF），并计算峰值射血率（PER）、舒张早期峰值充盈率（PFR）、PER／EDV、PFR／EDV。结果B、c、D组EDV、EsV显著大于A组，PFR／EDV显著小于A组（均P〈0．05）；C、D组EF、PER／EDV显著小于A组（均P〈0．05）。PER／EDV与EF有较好的相关性（r=0．694，P〈O．05）。A组17节段VTC排列有序，收缩期与舒张早期形态对称；B、C、D3组VTC形态与A组有明显不同，收缩期与舒张早期不对称。结论实时三维超声心动图容积时间曲线可客观评价左室收缩和舒张功能，PER／EDV、PFR／EDV可作为定量评价左室收缩功能和舒张功能的有效指标。

Objective To quantitatively assess left ventricular global systolic and diastolic function using volume-time curves （VTC） by real-time three-dimensional echocardiography（RT-3DE）. Methods Ninty-eight subjects were divided into four groups. Group A consisted of twenty-eight normal subject,group B included twenty-four patients with hypertensive（HTN）,group C consisted of twenty-four patients with coronary artery disease（CAD） and group D of twenty-two patients having dilated cordiomyopathy （DCM）. Participants were selected undergoing full volume RT-3DE. The global and 17-segmental VTCs were obtained by the off-line Qlab software. The end-diastolic volume（EDV）, end-systolic volume（ESV） and ejection fraction（EF） were derived from VTCs. The peak ejection rate（PER）, peak early filling rate （PFR）, PER/EDV and PFR/EDV were calculted. Results EDV and ESV of group B,C and D was significantly larger than that of group A（all P 〈 0.05） ,EF and PER/EDV of group C and D significantly lower than those of group A. There were close correlation between PER/EDV and EF （ r = 0.694, P 〈 0.05）. Comparison of VTC pattern of HTN,CAD and DCM with that of healthy participants revealed the loss of symmetry of systolic and diastolic pattern. Conclusions Generation of VTCs by RT3DE is a promising approach to evaluate left ventricular global systolic and diastolic function. PER/EDV and PFR/EDV may be potential parameters for assessing left ventricular global systolic and diastolic function.