冠状动脉病变支数对二维和三维超声心动图左室功能测量准确性的影响

Quantification of the Left Ventricular Function in Patients with Coronary Artery Disease by Twodimensional and Threedimensional Echocardiography:Impact of the Number of Coronary Artery Branch Stenosis

为了探讨冠状动脉病变支数对二维（２ＤＥ）和三维超声心动图（３ＤＥ）左室功能测量结果的影响，应用多平面经食管３ＤＥ技术测量了９例冠状动脉单支血管病变患者（Ａ组）及１１例多支血管病变患者（Ｂ组）的左室舒张末期容量（ＥＤＶ）、收缩末期容量（ＥＳＶ）、心搏量（ＳＶ）及射血分数（ＥＦ），并与２ＤＥ及左室造影（ＬＶＡ）的测值进行了对比，结果显示：①在Ａ、Ｂ两组患者中２ＤＥ测量的ＥＤＶ、ＥＳＶ、ＳＶ及ＥＦ与ＬＶＡ相应测值仅呈中度相关，３ＤＥ则均呈高度相关，且３ＤＥ所测ＥＤＶ、ＥＳＶ对左室造影结果的低估程度仅为２ＤＥ方法的一半；②在Ａ、Ｂ两组患者中，２ＤＥ所测ＥＦ均高于左室造影结果（Ｐ＜０．０１），３ＤＥ所测ＥＦ则与左室造影测值无显著性差异（Ｐ＞０．０５）。③Ｂ组患者的ＥＦ用２ＤＥ、３ＤＥ及ＬＶＡ三种方法测量均较Ａ组患者明显降低（Ｐ＜０．０５），而ＥＤＶ则显著增加（Ｐ＜０．０５）。

To evaluate the impact of the number of coronary artery branch stenosis on quantification of the left ventricular systolic function by twodimensional(2DE) and multiplane transesophageal threedimensional echocardiography(3DE),9 patients with stenosis of 1 branch of coronary artery (group A) and 11 patients with stenosis of 2 or 3 branches of coronary artery (hroup B) were examined with 2DE ,3DE and left heart catheterization(LVA) within 24 hours.The results showed that:1. in group A and group B,there were high correlations of EDV,ESV,SV and EF measured by 3DE and LVA;whereas there were only moderate correlations measured by 2DE and LVA;2.In group A and B,there were no siginificant differences between EF measured by 3DE and LVA, but EF measured by 2DE were overestimated(P<0.01).In conclusion,3DE provides a highly feasible approach to the measurement of the left ventricular volume and ejection fraction,and is superior to 2DE in quantitating left ventricular systolic function in patients with coronary artery disease.