实时三维超声心动图对左前降支经皮冠状动脉介入术后左室节段收缩功能与同步性的评价

Evaluation on the left ventricular segmental systolic function and synchrony after percutaneous coronary intervention on left anterior descending branch using real-time three-dimensional echocardiography

目的探讨实时三维超声心动图(RT-3DE)评价冠状动脉粥样硬化性心脏病(以下简称冠心病)患者左前降支经皮冠状动脉介入治疗(PCI)术后左室节段收缩功能与同步性的临床应用价值。方法对40例拟接受PCI术治疗的冠心病患者行RT-3DE检查,通过脱机分析左室17节段的时间-容积曲线,得到冠状动脉左前降支供血7节段的舒张末容积(r EDV)、收缩末容积(r ESV)、达到最小收缩容积时间的校正值(Tmsv%)及射血分数(r EF)。观察分析PCI术前、术后1周、1个月及3个月各参数的变化情况。结果与术前比较,术后1周r ESV和Tmsv%减低,r EF升高,差异均有统计学意义(均P<0.05),r EDV有所改善,差异无统计学意义;与术前、术后1周比较,术后1个月r EDV、r ESV及Tmsv%均减低,r EF升高,差异均有统计学意义(均P<0.05);术后3个月各参数仍有改善,但与术后1个月比较,差异均无统计学意义。结论 RT-3DE可定量评价冠心病患者左前降支PCI术后左室节段心肌收缩功能与同步性的改变,可作为评估PCI疗效的有效方法。

Objective To explore the clinical value of real-time three-dimensional echocardiography（RT-3DE）in evaluating left ventricular segmental systolic function and synchrony in coronary artery disease patients after percutaneous coronary intervention（PCI）on left anterior descending branch（LAD）. Methods Forty patients with coronary artery disease were treated with percutaneous coronary intervention on left anterior descending branch were selected. RT-3DE was performed and left ventricle function was evaluated before PCI on LAD, 1 week,1 and 3 months after therapy, respectively. The 7 segmental systolic function parameters（r EDV,r ESV,r EF） and synchronic parameter（Tmsv %） of LAD were obtained through the 17-segmental time-volumetric curves analysis. Results Compared with the povrameters before PCI,the r EF of 1 week after PCI were significantly increased,r ESV and Tmsv% was significantly decreased（P 0.05）,while r EDV had no significant difference.The r EDV,r ESV and Tmsv% of 1 month after PCI were significantly decreased,the r EF were significantly increased than those of prePCI and 1 week after PCI（all P〈0.05）. No significant differences of above parameters between 3 months and 1 month after PCI.Conclusion RT-3DE can qualitatively assess left ventricular segmental systolic functional and synchrony changes in coronary artery disease patients after PCI of LAD,which can effectively evaluate the effect of PCI.