实时三维超声心动图容积-时间曲线评价冠心病患者左室局部与整体心功能的研究  

Evaluation of Left Ventricular Regional and Global Function by Real-time Three-dimensional Echocardiographic Volume-time Curves in Patients with Coronary Artery Disease

作　　者：陈明[1] 谢明星[2] 王新房[2] 吕清[2] 王蕾[2] 

机构地区：[1]南方医科大学附属深圳宝安医院超声科,广东省深圳市518101 [2]华中科技大学同济医学院附属协和医院超声影像科

出　　处：《中国超声医学杂志》2010年第8期705-709,共5页Chinese Journal of Ultrasound in Medicine

摘　　要：目的应用实时三维超声心动图(RT-3DE)评价冠心病患者左室局部与整体收缩和舒张功能。方法根据冠状动脉造影将病变组分为左旋支或/和右冠支病变组(LCX/RCA组)24例、单纯左前降支病变组(LAD组)21例、包含LAD的双支或多支病变组(多支组)27例;以及正常对照组22例,采集各研究对象左室全容积图像,在分析软件上获得局部峰值充盈率/射血率(rPFR/rPER)、整体峰值充盈率/射血率(gPFR/gPER)和左室射血分数(LVEF)。结果绝大多数狭窄冠状动脉供血节段的rPFR、rPER较之相应正常冠状动脉供血节段显著减低(P<0.05或P<0.01);正常对照组、LCX/RCA组、LAD组、多支组间gPFR、gPER、LVEF依次递减(P<0.05或P<0.01)。相关性分析表明各组各节段内rPFR与rPER(r=0.89～0.99,P<0.01),各组内gPFR与gPER(r=0.975～0.985,P<0.01)、以及gPER与LVEF(r=0.878～0.980,P<0.01)均呈良好的相关性。结论 RT-3DE测量rPFR、rPER、gPFR、gPER、LVEF能全面反映冠心病患者左室局部与整体的舒张和收缩功能,为临床提供更完整的信息。Objective To assess regional and global left ventricular systolic and diastolic function in patients with coronary artery disease （CAD） by real-time three dimensional echocardiographical volume time curves （RT-3DE VTC）. Methods According to coronary artery angiography, single main vessel stenosis equal to or larger than 50% was defined as positive standard. Full volumetric RT-3DE data of 24 patients with left circumflex coronary artery or/ and right coronary artery stenosis （LCX/RCA group ）, 21 patients with single left anterior descending coronary artery stenosis （LAD group）, 27 patients with double or triplex coronary arteries stenosis, which must include LAD （Vessels group） and 22 subjects （normal controls group） were acquired. The regional peak filling /ejection rate （rPFR/rPER）, global peak filling/ ejection rate （gPFR/gPER） and left ventricular ejection fraction （LVEF） were obtained by 4D LV analysis CAP 2.5 software of TomTec company. Results rPFR and rPER of most sections where coronary artery had positive stenosis were significantly lower than those of corresponding sections where coronary artery had no positive stenosis inter group （P〈0.05 or P〈0.01）, respectively, except a few sections. The rPFR, rPER, gPFR, gPER, LVEF significantly decreased in order （P〈0.05 or P〈0.01） in normal controls group, LCX/RCA group, LAD group, Vessels group, respectively. Correlation analysis indicated good positive correlations between rPFR and rPER of each section （r=0.891-0.990, P〈0.01） .Good positive correlations between gPFR and gPER （r=0.975~0.985, P^0.01）, as well as between gPER and LVEF （r=0.878-0.980, P〈0.01） in each group were found, respectively. Conclusions RT-3DE can provide a new noninvasive and accurate tool for as- sessment of left ventricular regional and global diastolic and systolic function in CAD with rPFR, rPER, gPFR, gPER, LVEF parameters.

关 键 词：实时三维超声心动描记术 容积-时间曲线 左心功能 冠状动脉疾病 

分 类 号：R540.45[医药卫生—心血管疾病]