三维超声心动图估测功能性单心室心功能及同步性

Study on the assessment of heart function in children with functional single ventricle by three dimensional echocardiography

目的应用三维超声心动图评估功能性单心室患儿的整体心功能及同步性,探讨三维超声心动图在功能性单心室患儿的应用。方法研究对象分两组,病例组为36例功能性单心室患儿,对照组为36例正常儿童,应用Q-lab软件分析并计算单心室主心腔及正常儿童左心室的舒张末期容积(EDV)、收缩末期容积(ESV)、射血分数(EF)、16节段达到收缩末最小容积时间的标准差和最大差值(Tmsv16-SD、Tmsv16-Dif)、被标准化为心动周期的百分比(Tmsv16-SD%、Tmsv16-Dif%)、12节段达到收缩末最小容积时间的标准差和最大差值(Tmsv 12-SD、Tmsv 12-Dif)、被标准化为心动周期的百分比(Tmsv 12-SD%、Tmsv 12-Dif%)。结果病例组的EDV(48.64±33.62)ml明显大于对照组的EDV(35.82±16.71)ml,P<0.05。病例组的ESV(25.12±19.81)ml明显大于对照组的ESV(11.42±5.94)ml,P<0.05。功能性单心室患儿的EF(49.80±8.83%)明显小于正常儿童的EF(68.26±5.50%),P<0.05。功能性单心室患儿的Tmsv16-SD、Tmsv16-Dif、Tmsv16-SD%、Tmsv16-Dif%、Tmsv 12-SD、Tmsv 12-Dif、Tmsv 12-SD%及Tmsv 12-Dif%与正常儿童相比,有明显增大,P<0.05。结论功能性单心室患者存在收缩功能不全及不同步,实时三维超声心动图可评估功能性单心室患者整体心功能及同步性。

Objective To explore the value of three-dimensional echocardiography （3DE） for assessment of globe yen tricular function and synchronicity in functional single ventricle（FSV）. Methods Seventy-two subjects were divided into two groups. Thirty-six healthy volunteers and thirty-six patients with FSV were enrolled in this study. There were no sig- nificant difference in age, sex, heart rate between the two groups. 3DE data were acquired with the IE 33 system then ana- lyzed by Q-lab software. End-diastolic volume （EDV） , end-systolic volume （ESV） and eject fraction （EF） were acquired by RT-3DE. The percentage of standard deviation and maximal difference of the time to minimal systolic volume in ap- pointed segments （Tmsv） were standardized by cardiac cycle such Tmsv 16 SD~, Tmsv 12 SD~, Tmsv 16-Dif~ and Tmsv 12 Dif% as the indexes of left ventricular systolic synchronicity. Results The ventricular volumes and function in patients with FSV were （48. 64＋_33. 62） ml （ end diastolic volume）, （25. 12~19. 81） ml （end systolic volume）, and 49.80＋8.83~ （ejection fraction）. The ventricular volumes and function in healthy volunteers were （35.82--＋ 16.71 ） ml （end-diastolic volume）, （11.42＋5.94） ml （end-systolic volume）, and 68.26 -＋5.50~ （ejection fraction）. There were significant differences in EDV, ESV and EF between healthy volunteers and patients with FSV, P %0.05. There were significant differences in Tmsvl6-SD, Tmsvl6-Dif, Tmsv16-SD~, Tmsvl6-Dif%, Tmsv 12 SD, Tmsv 12-Dif, Tmsv 12- SD% and Tmsv 12-Dif% between healthy volunteers and patients with FSV, P %0.05. Conclusion Poorer globe ventric- ular function and dyssynchronyv were exited in patients with FSV. Globe ventricular function and synchronicity in patients with FSV can be quantified by 3DE.