左心室同步性指标预测冠状动脉旁路移植术后左心室逆重构的价值  

The Value of Predicting Left Ventricular Reverse Remodeling after Coronary Artery Bypass Graft Using the Left Ventricular Synchronized Indices

作　　者：张连仲[1] 边晓琳[1] 权晓强[2] 程兆云[2] 马桂英[1] 段少博[1] 

机构地区：[1]河南省人民医院超声科,郑州市450003 [2]河南省人民医院心外科,郑州市450003

出　　处：《中国超声医学杂志》2010年第2期138-141,共4页Chinese Journal of Ultrasound in Medicine

摘　　要：目的探讨实时三维超声心动图(RT-3DE)左心室同步性指标预测冠心病(CAD)患者冠状动脉旁路移植术(CABG)后左心室逆重构价值。方法经选择性冠状动脉造影证实为3支冠状动脉病变的31例CAD患者,应用RT-3DE于术前及术后1个月测量左心室舒张末容积(LVEDV)及16节段同步性等指标,依据CABG术后LVEDV减少≥15%为左心室逆重构标准将病例组分为有反应组(A组,LVEDV减少≥15%)和无反应组(B组,LVEDV减少<15%),并与20例冠状动脉正常的受检者对比分析,且对CAD患者LVEDV与左心室16节段达峰时间最大差值(Tmsv16-Dif)及标准差(Tmsv16-SD)做相关分析。结果与对照组比较,CAD患者手术前后左心室同步性指标均显著降低(P<0.01);与术前比较,A组左心室同步性有显著提高(P<0.01),B组则无明显提高改善(P>0.05)。CAD患者LVEDV与左心室Tmsv16-Dif及Tmsv16-SD均呈显著正相关(分别为r=0.751,P<0.01;r=0.655,P<0.01)。结论 CABG术后发生左心室逆重构的患者其同步性提高,且LVEDV与左心室同步性指标相关良好,此表明左心室同步性指标亦可作为一种新的预测心室逆重构的方法应用于临床。Objective To investigate the value of predicting left ventricular reverse remodeling in patients after coronary artery bypass graft by using the left ventricular synchronized indices derived from real time three dimensional echocardiography. Methods Left ventricular end-diastolic volume （LVEDV） and 16-segments synchronized indices were measured by Real-time three-dimensional echocardiography （RT3DE） in 31 patients with three-vessels of coronary artery disease （CAD） before and 1 month after coronary artery bypass grafting （CABG） and control group . The patients group was divided into responding group （group A, reduction of LVEDV≥15% 1 month after CABG） and non-responding group （group B, reduction of LVEDV〈15 % 1 month after CABG） . All the data were compared between patients group and control group. The correlation of LVEDV and Tmsv16-SD as well as Tmsv16-Dif was analysed statistically. Results Compared with control group, the left ventricular synchronized indices significantly decreased in patients group including pre and post-operation cases （P〈0.01） . Compared with pre-operative period, the left ventricular synchronized indices were significantly increased in group A （P〈0.01） . On the contrary, there was no significant change in group B （P〉0.05） . In CAD group, there were obvious positive correlations between LVEDV and Tmsv16-SD as well as Tmsv16-Dif （r=0.751, P〈0.01; r=0.655, P〈0.01） .Conclusions The synchronization had significant improvement in patients with reverse remodeling of left ventricle after CABG, and there were positive correlations between LVEDV and Tmsv16-SD as well as Tmsv16-Dif. Hence Tmsv16-SD and Tmsv16- Dif could be a new kind of indices to predict left ventricular reverse remodeling.

关 键 词：超声心动描记术 冠状动脉旁路移植术 左心室逆重构 同步性 

分 类 号：R540.45[医药卫生—心血管疾病] R654.2[医药卫生—内科学]