单心动周期全容积成像评价心肌梗死患者左心室收缩功能和收缩同步性

Evaluation of Left Ventricular Systolic Synchrony and Its Systolic Function in Patients with Myocardial Infarction using Single Beat Real-time Four Dimensional Echocardiography

目的探讨应用单心动周期实时四维超声心动图(single beat real—time four dimensionalechocardiography.sRT-4DE)评价心肌梗死患者左室整体节段舒缩功能及室壁运动同步性,左室收缩缩功能对左心室室壁运动同步性的影响.方法研究对象分为2组:心肌梗死组40例,其中陈旧性前壁心肌梗死15例;正常组30例,均行实时四维超声心动图检查,通过左室分析软件获得整体及节段容积一时间曲线及左室整体及节段收缩功能参数、左室收缩同步性参数.结果心肌梗死组左室收缩未期容积(ESV)、左室舒张末期容积(EDV)显著大于正常组(P<0.01).左室射血分数(LVEF)显著小于正常组(P<0.01);心肌梗死组左室16节段收缩同步性参数显著大于正常组(P<0.01),其中SDI与LVEF的相关系数r=-0.521,P<0.01.与正常组相比,心肌梗死组16个节段的Dispes16、ESSI增大(P<0.05).结论 sRT-4DE能够准确评价心肌梗死患者左室收缩同步性及收缩功能,左室整体及节段收缩减退可影响左室室壁运动的同步性.

Objective To evaluate the left ventricular systolic synchrony and systolic function, and investigate the relation between left ventricular systolic synchrony and its systolic function in the patients with myocardial infarction using single beat real-time four dimensional echocardiography （sRT-4DE） Methods Forty patients with myocardial infarction including 15 cases of old anterior myocardial infarction and 30 healthy adults were conducted sRT-4DE. The full-volume imaging was performed and the data was analyzed by left ventricular analysis （LVA） software. A series of global and regional left ventricular volume curves were plotted. The parameters of left ventricular systolic function and synchrony in global and regional cardiac ventricle were obtained. Results In the myocardial infarction group, the ESV and EDV were larger and the LVEF was lower than those of the control group （P 〈 0.01） . The systolic synchrony parameters were significantly greater in the myocardial infarction （P 〈 0.001） . The correlation coefficient of SDI and LVEF was r = -0.521, P 〈 0.01. Compared with the control group, the Dispesl6 and ESSI increased （P 〈 0.05） in the myocardial infarction group. Conclusion sRT-4DE could evaluate the left ventricular systolic synchrony and systolic function in patients with myocardial infarction accurately. The left ventricular systolic dysfunction could affect the synchrony of left ventricular regional wall motion.