实时三维超声心动图评价AMI患者CABG术后左心室重构

Evaluation of Left Ventricular Remodeling in Patients with AMI after CABG Using RT-3DE

目的探讨急性心肌梗死(Acute myocardial infarction,AMI)患者冠状动脉旁路移植术(Coronary artery byass graft,CABG)术后左心室的重构及实时三维超声心动图对其的定量评价。方法应用实时三维超声心动图对33例急性心肌梗死患者行CABG术前、及术后1周、1年左室舒张末期容积、收缩末期容积、射血分数、左心室质量指数进行测量,并进行术前、术后比较分析,并与对照组进行比较。结果手术组患者术前LVEDV、LVESV、LVMI的结果较正常对照组增大(P(0.05),LVEF减低(P(0.05)。手术组术后1周与术前比较:LVEDV、LVESV、LVMI的结果较术前增大(P(0.05),LVEF减低(P(0.05)。手术组术后1年与术前比较LVEDV、LVESV、LVMI的结果较术前减少(P(0.05),LVEF增加(P(0.05)。结论冠脉搭桥手术可逆转左室重构,实时三维超声心动图可定量对其进行评价。

Objective To discuss the quantitive evaluation of left ventficular remodeling in patients with AMI after CABG by using RT-3DE. Methods Data of 33 patients with AMI after CABG were acquired by using RT-3DE. The left ventficule end diastolic volume （LVEDV）, left ventricule end systolic volumeLV （ESV）, stroke volume （SV）, ejection fraction （EF） and mass index of 1 eft ventficule were measured before CABG, one week, one year after CABG, and made comparative analysis, and compared with those of the control group as well. Results The LVEDV, LVESV and 1 eft ventricular mass index （LVMI） in patients with AMI were significantly higher before CABG than those in the normal control group （P〈0.05）, and LVEF was significantly lowered （ P〈0. 05 ） ; one week after CABG, the LVEDV, LVESV and left ventficular mass index （LVMI） in patients with AMI were high compared with those before CABG （ P 〉 0. 05 ） and LVEF was lower （P 〉 0.05 ） ; one year after CABG, the LVEDV, LVESV and 1 eft ventricular mass index （LVMI） in patients with AMI were significantly lower than those before CABG （P〈0.05）, and LVEF was significantly higher （P〈0. 05）. Conclusions Coronary artery bypass grafting can reverse left ventricular remodeling, which can be quantitively evaluated by RT-3DE.