实时三维超声心动图定量评价陈旧性前壁心肌梗死患者左室整体和节段收缩功能

Quantitative Assessment of Global and Regional Left Ventricular Systolic Function in Patients with Old Anterior Myocardial Infarction by Real-Time Three-Dimensional Echocardiography

目的:运用实时三维超声心动图(RT-3DE)检测陈旧性心肌梗死患者左室整体和节段收缩功能的改变。方法:运用RT-3DE检查25例正常人和20例陈旧性前壁心肌梗死(OMI)患者,获取左室整体和17节段容积-时间曲线,比较两组的整体和节段舒张末期容积(EDV、rEDV)、整体和节段收缩末期容积(ESVr、ESV)、整体和节段射血分数(EF、rEF)及节段-整体射血分数(rgEF)。结果:OMI组整体EDV、ESV及梗死节段rEDV、rESV较对照组增大,整体EF、梗死节段rEFr、gEF降低(P<0.05)。心尖部rEDVr、ESV增大,rEF、rgEF较对照组降低,部分非梗死节段rEF、rgEF较正常组增大(P<0.05),余节段无明显差异。结论:陈旧性前壁心肌梗死后左室整体、梗死节段及心尖部收缩功能下降,部分未梗死节段心功能代偿性增强。RT-3DE可准确定量评价心肌梗死后左室整体和局部容积及收缩功能的改变。

Objective： To evaluate the change of global and regional left ventricular systolic function in patients with old anterior myocardial infarction by real-time three-dimensional echocardiography （RT-3DE）. Methods： Twenty five normal subjects and 20 patients with old anterior myocardial infarction were studied. RT-3DE was performed and a series of global and regional left ventricular volume curves were plotted. The global and regional diastolic volumes （EDV, rEDV）, the global and systolic volumes （ESV, rESV）, the global and ejections farctions （EF, rEF）, and regional stroke volume to global diastolic volume （rgEF） were compared respectively between the two groups. Results： Compared with that in normal group respectively, the patients＇ EDV, ESV, rEDV, and rESV were larger （all P〈0.05）, while EF, rEF and rgEF were lower （P〈 0.05）. The apical volumes were larger, while rEF and rgEF were lower. And in some non-infarction regional, the rEF, rgEF were larger. No significant statistic changes were found in the rest non-infaretion regional. Conclusion： The global and regional with infarction of left ventricular function were lower in patients with old anterior myocardial infarction, and the function in some distal regional enhanced compensatively. RT-3DE can evaluate the change of left ventricular volume and systolic function accurately and quantitatively.