实时三维超声心动图评价不同部位心肌梗死患者左心室收缩功能与同步性  

Evaluation of left ventricular systolic function and dyssynchrony in patients with myocardial infarction in different location by real-time three-dimensional echocardiography

作　　者：关秀萍[1] 邓倾[2] 朱丽敏[2] 周青[2] 

机构地区：[1]武汉大学医院超声科,武汉市430072 [2]武汉大学人民医院超声影像科

出　　处：《临床超声医学杂志》2010年第10期657-660,共4页Journal of Clinical Ultrasound in Medicine

摘　　要：目的应用实时三维超声心动图(RT-3DE)评价前壁和下壁心肌梗死(心梗)患者左室整体和节段收缩功能及同步性,探讨梗死部位对左心室收缩功能及同步性的影响。方法用RT-3DE对41例心梗患者(其中前壁心梗28例,下壁心梗13例)及30例健康体检者(对照组)进行17节段时间-容积曲线分析,获取心梗组及对照组的左室整体和节段舒张末期容积(EDV、rEDV)、收缩末期容积(ESV、rESV)、射血分数(EF、rEF),以及16节段从QRS波起点到最小收缩容积时间的标准差和最大差值及其校正值(Tmsv 16-SD、Tmsv 16-Dif、Tmsv 16-SD%、Tmsv 16-Dif%),其中Tmsv 16-SD%为左室收缩不同步指数(SDI)。结果心梗组整体EDV、ESV及梗死节段的rEDV、rESV均较正常组增大,EF及rEF均减低,且前壁心梗组的这种改变较下壁心梗组更显著;心梗组SDI较正常组增大,前壁心梗组SDI较下壁心梗组增大,EF与SDI呈良好负相关。结论前壁心肌梗死对左心室收缩功能及同步性的影响均较下壁心肌梗死大。Objective To evaluate the global and regional systolic function and dyssynchrony of the left ventricle in anterior and inferior myocardial infarction （MI） by real -time three -dimensional echocardiography （RT -3DE ）, and to explore the effect of MI location on LV systolic function and dyssynchrony. Methods RT -3DE was performed on 41 patients with MI （ including 28 cases of anterior MI and 13 cases of inferior MI ） and 30 normal suhjects. The 17 - segmental time - volumetric curves were analyzed, the global systolic function parameters （EDV, ESV, EF）, regional systolic function parameters （rEDV, rESV, rEF） and dyssynchronic parameters （Tmsv 16 - SD, Tmsv 16 - Dif, Tmsv 16 - SD% , Tmsv 16 - Dif% ） were obtained, the Tmsv 16 - SD% was served as the systolic dyssynchrony index （SDI）. Results Compared with the normal control group, the global EDV , ESV and regional rEDV, rESV in MI group were increased , while the EF and rEF were decreased. The dyssynchronic parameters in MI group was significantly higher than that in normal control group, and SDI was negatively correlated with the EF. The dyssynchronic degree in the anterior MI group was higher than that of the inferior MI group. Conclusion Compared with inferior MI, the effect of anterior MI on LV systolic function and dyssynchrony is higher.

关 键 词：超声检查 三维 心肌梗死 收缩功能 同步性 

分 类 号：R542.22[医药卫生—心血管疾病] R445.1[医药卫生—内科学]