实时三维超声容积时间曲线评价冠脉搭桥术前后左室收缩功能的变化

Assessment of left ventricular systolic function in patients before and after coronary artery bypass grafting using volume-time curve by real-time three-dimensional echocardiography

目的应用实时三维超声心动图(RT-3DE)容积-时间曲线(VTC)评价非体外循环冠状动脉搭桥术(OPCABG)前后左室整体收缩功能的变化。方法选择行OPCABG的冠心病患者30例作为手术组,另选20例健康者作为对照组。应用RT-3DE检测对照组及手术组术前、术后左室整体舒张末容积(EDV)、射血分数(EF)、峰值射血率(PER),并计算PER/EDV。结果手术组术前及术后EDV较对照组增大(P<0.05),EF、PER/EDV较对照组减小(P<0.05);手术组术后EDV较术前减小(P<0.05),EF、PER/EDV较术前增加(P<0.05)。EF与PER/EDV有较好的正相关性(r=0.603,P<0.05)。手术组术前、术后及对照组间PER均无明显改变(P>0.05)。结论OPCABG手术后左室整体收缩功能提高;应用RT-3DE容积-时间曲线参数PER/EDV可以定量评估冠心病患者OPCABG手术前后左室整体收缩功能的改变。

Objective To assess the changes of global systolic function of left ventricular（LV）in patients with coronary artery disease （CAD） before and after off-pump coronary artery bypass grafting（OPCABG） using volume-time curve （VTC）by real-time three-dimensional echocardiography（RT-3DE）. Methods RT-3DE was performed in 30 patients with CAD before and after OPCABG and 20 healthy controls. Global LV end-diastolic volume （EDV）, ejection fraction （EF）, peak ejection rate （PER）, PER/EDV were measured and calculated. Results Compared with that before OPCABG,EDV decreased in patients after OPCABG（ P 〈 0.05 ）, and EF and PER/ EDV increased（ P 〈0.05 ）. Compared with healthy controls,EDV increased in patients before and after OPCABG（ P 〈0.05 ） ,and EF and PER/EDV decreased （ P 〈 0.05 ）. A positive correlation was found between EF and PER/EDV （ r = 0. 603,P 〈 0.05 ）. There was no significant difference in PER among health controls, patients before and after OPCABG. Conclusion After OPCABG, global LV systolic function is improved. PER/EDV derived from VTC by RT-3DE can quantify the changes of global systolic function of left ventricular in patients with CAD before and after OPCABG.