三维超声心动图自动定量技术评估冠心病患者经皮冠状动脉介入术后左心室容积及收缩功能

Evaluation on left ventricular volume and systolic function with three-dimensional echocardiographic automated algorithm in patients with coronary heart disease after percutaneous coronary intervention

目的探讨三维超声心动图自动定量(3DEA)技术对评估冠心病(CHD)患者经皮冠状动脉介入(PCI)术后左心室收缩功能的临床应用价值。方法选取50例行PCI的CHD患者,分别于术前及术后1个月、3个月行超声心动图检查,应用二维双平面Simpson's法(2DBP)及3DEA技术测量左心室舒张末期容积(LVEDV)、左心室收缩末期容积(LVESV)及左心室射血分数(LVEF)。结果3DEA测量的LVEDV、LVESV及LVEF与2DBP法测值相关性高(r=0.92、0.90、0.84);与PCI术前相比,3DEA技术及2DBP法测量的PCI术后1个月、3个月LVEDV、LVESV均减低,LVEF均增加(P均<0.05),与PCI术后1个月比较,PCI术后3个月3DEA测量的LVEDV、LVESV减低,LVEF增加(P均<0.05),而2DBP测量的LVEDV、LVESV及LVEF差异均无统计学意义(P均>0.05)。与2DBP比较,3DEA技术分析时间短、重复性高(P均<0.05)。结论3DEA技术分析时间短、重复性高,与2DBP测值相关性高,能监测到PCI术后左心室容积及功能改善,对冠心病患者PCI术后疗效评估及长期随访具有临床应用价值。

Objective To evaluate left ventricular systolic function in patients with coronary heart disease(CHD)after percutaneous coronary intervention(PCI)with three-dimensional echocardiographic automated algorithm(3DEA).Methods Fifty patients with CHD were enrolled.Left ventricular end-diastolic volume(LVEDV),end-systolic volume(LVESV)and ejection fraction(LVEF)were measured before PCI and 1 month and 3 months after PCI by using 3DEA and two-dimensional biplane Simpson's(2DBP)methods.Results LVEDV,LVESV and LVEF measured with 3DEA significantly correlated with those with 2DBP(r=0.92,0.90,0.84).Compared with measurements before PCI,LVEDV and LVESV measured with 3DEA and 2DBP methods decreased,while LVEF increased 1 month and 3 months after PCI(all P<0.05).Compared with one month after PCI,LVEDV,LVESV and LVEF measured with 3DEA further improved 3 months after PCI(all P<0.05),whereas LVEDV,LVESV and LVEF measured with 2DBP were not significantly different(all P>0.05).The time of 3DEA was short,and the reproducibility was higher than that of 2DBP(both P<0.05).Conclusion 3DEA method is rapid and highly reproducible and highly correlated with 2DBP,therefore may be a useful technique in serially following patients with CHD and assessing responses to PCI.