实时三维超声心动图定量评价扩张型心肌病患者心室内收缩同步性的研究  

Real-time three-dimensional echocardiographic quantification of left ventricular systolic synchronicity in patients with dilated cardiomyopathy

作　　者：曾欣[1] 舒先红[1] 潘翠珍[1] 陈瑞珍[1] 程宽[1] 刘诗珍[1] 陈灏珠[1] 

机构地区：[1]复旦大学附属中山医院超声心动图室上海市心血管病研究所,上海200032

出　　处：《中华超声影像学杂志》2007年第2期97-100,共4页Chinese Journal of Ultrasonography

摘　　要：目的探讨实时三维超声心动图评价扩张型心肌病（DCM）患者左室内收缩同步性的临床应用价值。方法对32例DCM患者和31例正常志愿者应用超声技术获取左心室的全容积图像。计算左室17节段达到收缩期最小容积点的时间（Tmav），并计算出左室16节段、12节段及6个基底段达到Tmav的标准差和最大时间差（即Tmav，16-SD，Tmav 16-Dif，Tmav12-SD，Tmav12-Dif，Tmav6-SD和Tmav6-Dif）。结果DCM组的各项收缩不同步指标均显著高于正常组（均P〈0．01）。与DCM伴左室收缩功能轻度减退组相比，DCM伴左室收缩功能中重度减退组的Tmav，16-SD、Tmav12-SD、Tmav 16-Dif等指标均显著增高（均P〈0．01）。所有受检者的全容积三维法测量的左室射血分数与二维Simpson法的测值呈高度正相关关系（r=0．912，P〈0．001）。结论实时三维超声心动图及其定量分析软件能在同一心动周期内比较左室各节段的同步性，并提供血流动力学方面的信息，为临床评价左室内不同步提供了简便、直观、无创性的新方法。Objective To quantitatively evaluate the left ventricular（LV） systolic synchronicity in patients with dilated cardiomyopathy （DCM） by real-time three-dimensional echocardiography （RT-3DE）. Methods Thirty-two patients with DCM and thirty-one healthy volunteers were enrolled in this study. Full volume RT-3DE was performed using Philips IE33 with the S5-1 2D transducer and the X3-1 matrix array 3D transducer. The global and 17-segmental time-volume curves were obtained by the off-cart Qlab software （version 4. 2）. The asynchrony timing and indexes were derived from the basal, mid, and apical 16-segmental volumes, excluding the apical cap. The time to minimal systolic volume（Tmav） in each segment was taken to derive the following indexes of systolic asynchrony.. Tmav 16-SD,Tmav 16-Dif,Tmav 12-SD,Tmav 12-Dif,Tmav 6-SD and Tmav 6-Dif. Results ①All the indexes of systolic asynchrony mentioned above were significantly larger in the DCM group than those of the control group （all P d0.01）. ②Tmav 16-SD,Tmav 12-SD,Tmav 16-Dif and Tmav 12-Dif were significantly larger in the subgroup DCM patients with moderate to severe LV dysfunction than those with mild LV dysfunction. ③The LVEF determined by Simpson＇s modified biplane method correlated closely with LVEF determined by RT3DE （ r = 0. 912, P 〈0. 001）. Conclusions RT-3DE provides a simple,intuitional and noninvasive approach to assess the systolic synchronicity of all the LV segments simultaneously.

关 键 词：超声心动描记术 实时三维 心肌病 扩张型 心室功能 左 心力衰竭 充血性 

分 类 号：R686[医药卫生—骨科学]