超声心动图对行PCI术后的室壁瘤患者左心室形态及整体收缩功能的评价

Echocardiography in evaluation of left ventricular morphology and global cardiac systolic function of left ventricular aneurysm PCI patients

目的:应用超声心动图评价左心室室壁瘤(LVA)患者行PCI后左心室形态、容积及整体收缩、舒张功能的变化。方法:对42例LVA患者(观察组)和38例急性心肌梗死(AMI)(前壁)患者(对照组)分别于PCI术后1周、3个月行超声心动图检查。采集二维相关指标:左心室射血分数(LVef)、短轴缩短率(FS)、二尖瓣口舒张期血流E峰、A峰并计算出E/A比值。三维相关指标:LVEF、左心室舒张末期容积(LVEDV)、收缩末期容积(ESV),每搏输出量(SV)、心排血量(CO)及左心室球形指数(SPI),舒张末期容积指数(EDVI)、收缩末期容积指数(ESVI)及心脏指数(CIL)。并将各参数进行比较,了解患者术后心功能的变化。结果:AMI组和LVA组三维SPI、LVEF、SV、CO、CIL及二维LVef、FS术后1周、3月差异有统计学意义(P<0.05);AMI组的E峰差异有统计学意义(P<0.05),LVA组的E峰差异无统计学意义(P>0.05);两组EDV、ESV、EDVI、ESVI、A峰、E/A比值差异无统计学意义(P>0.05)。LVA组SPI恢复情况好于AMI组,LVEF、SV、CO、CIL及二维LVef、FS恢复不及AMI组。结论:LVA患者PCI术后3月比术后1周左心室形态及整体收缩功能改善,容积及舒张功能恢复不明显。

Objective：Apply echocardiography to evaluate the changes of left ventricular shape,volume and systolic and diastolic function of LVA patients in 1 week and 3 months after PCI. Methods：Observation group 42 patients with LVA and control group 38 patients with acute myocardial infarction （AMI） （anterior wall） were examined by echocardiography in 1 week and 3 months after PCI respectively. Collected two-dimensional correlative index：left ventricular ejection fraction （LVef）, short axial shortening（ FS ）, E peak and A peak of mitral diastolic velocity, and then calculated the E/A ratio. Three-dimensional correlative indexes：LVEF,left ventricular end diastolic volume （LVEDV）, end systolic volume（ ESV ）, stroke volume（SV ）, cardiac output（CO ） and left ventricular spherical index（SPI ）, end diastolic volume index（ EDVI ）, end systolic volume index （ESVI） and cardiac index （CI）. And the parameters were compared with each other to understand the changes of cardiac function after operation. Results：In AMI group and LVA group, the difference of 3DE SPI, LVEF, SV, CO, CI and two-dimensional LVef, FS in 1 week and 3 months after PCI has statistical significance（P 〈 0.05 ） ;For AMI group, E peaks difference has statistical significance （P〈 0.05）, For LVA group, E peak difference has no statistical significance （P 〉 0.05 ）; the difference of EDV, ESV,EDVI, ESVI, A peak,E/A ratio in the two groups has no statistical significance （P〉 0.05）. SPI recovery in LVA group is better than AMI group,and LVEF,SV,CO, CI and two-dimensional LVef, FS recovery is less than AMI group. Conclusion：Patients with LVA have improved in left ventricular morphology and its global systolic function, but its volume and diastolic function don＇t have obvious improvement three months after PCI operation comparing with one week before PCI operation.