实时三维超声心动图评价陈旧性心肌梗死患者左心室收缩同步性与收缩功能  

Three-dimensional echocardiographic assessment of left ventricular systolic synchrony and systolic function in patients with myocardial infarction

作　　者：贾妍[1] 郭瑞强[1] 陈金玲[1] 初洪钢[1] 

机构地区：[1]武汉大学人民医院超声影像科,湖北武汉430060

出　　处：《中国医学影像技术》2010年第1期75-78,共4页Chinese Journal of Medical Imaging Technology

摘　　要：目的应用实时三维超声心动图(RT-3DE)评价陈旧性心肌梗死患者左心室收缩同步性与收缩功能,并探讨左心室收缩同步性对左心室整体及局部收缩功能的影响。方法对陈旧性心肌梗死组30例(心梗组,其中陈旧性前壁心梗14例)及20名正常人(正常组)行RT-3DE检查,通过脱机软件分析整体及节段容积-时间曲线,获取左心室整体及节段收缩功能参数、左心室收缩同步性参数。结果心梗组左心室ESV、EDV显著大于正常组(P<0.01),LVEF显著小于正常组(P<0.001)。心梗组左心室16及12节段收缩同步性参数显著大于正常组(P<0.001),且均与LVEF呈负相关,其中Tmsv-16-SD%、Tmsv-16-Dif%相关性最高,r值分别为-0.755、-0.747。前壁心梗组梗死节段及邻近节段rEF、rgEF显著减低(P<0.05),Tmsv%明显延长(P<0.05),部分未梗死节段Tmsv%出现不同程度缩短,但差异无统计学意义,且前壁心梗组Tmsv%明显延长的节段与rEF、rg-EF明显减低的节段基本呈对应关系。结论RT-3DE能定量评价心肌梗死患者左心室收缩同步性及收缩功能,左心室不同步运动可影响左心室收缩功能。Objective To assess left ventricular systolic synchrony and systolic function,as well as the relationship between left ventricular systolic synchrony and systolic function in patients with myocardial infarction with real-time three-dimensional echocardiography（RT-3DE）.Methods Thirty patients with myocardial infarction and 20 healthy subjects underwent RT-3DE.Full-volume imaging was performed and the data was analyzed.A series of global and regional left ventricular volume curves were plotted.The parameters of left ventricular systolic function,synchrony in global and regional cardiac ventricle were obtained.Results ESV,EDV were larger and the LVEF was lower in the group of patients with myocardial infarction than those of the control group（P 〈0.01）.All the systolic synchrony parameters were significant larger in patients with myocardial infarction than in the control group（P 〈0.001）.The LVEF values,especially Tmsv-16-SD% and Tmsv-16-Dif%,were negative correlated with all the systolic synchrony parameters（r =-0.755,-0.747）.The regional left ventricular systolic function parameters（rEF and rgEF）were lower and the Tmsv% was longer（P〈 0.05）in the zones with infarction in patients with anterior myocardial infarction than those of the control group.The changes of Tmsv% were in coincidence with that in regional left ventricular systolic function.Conclusion RT-3DE can be used to evaluate left ventricular systolic synchrony and systolic function.The left ventricular systolic asynchrony has negatively effect on systolic function.

关 键 词：超声心动描记术 三维 心肌梗死 心室功能 左 

分 类 号：R540.45[医药卫生—心血管疾病] R541.4[医药卫生—内科学]