实时三维超声心动图定量评价左室心尖球形综合征患者左心室收缩不同步性  

Quantitative evaluation of left ventricular systolic dyssynchrony in patients with left ventricular apical ballooning syndrome by real-time three-dimensional echocardiography

作　　者：邓玉姣[1] 夏稻子[1] 李阳[1] 王晓鹏[2] 宣健媛[1] 孙明亮[1] 朱天彤[1] 

机构地区：[1]大连医科大学附属第二医院超声科,116027 [2]大连医科大学附属第二医院心内科,116027

出　　处：《中华超声影像学杂志》2013年第6期484-487,共4页Chinese Journal of Ultrasonography

摘　　要：【摘要】目的应用实时三维超声心动图（RT-3DE）定量评价不同时期左室心尖球形综合征（LVABs）患者左室收缩不同步性及与左室整体射血分数的相关性。方法LVABS患者7例．于人院时（入院第1～3d）、4周末、8周末应用RT一3DE采集左室实时三维全容积数据库图像，启动“4DI。VVolumeTom—Tec”软件，测量左室射血分数（LVEF），并获取左室16节段时间一容积曲线，得到各节段达最小收缩容积的时间（Tmsv），分别计算出16节段、基底段、中间段、心尖段Tmsv的标准差和最大差值（Tmsvl6-SD／Dif、Tmsvbasal—SD／Dif、Tmsv—mid—SD／Dif、Tmsvapical-SD／Dif）。并对左室收缩不同步指数（SDI）与LVEF进行相关性分析。结果①与人院时相比．4周末、8周末Tmsvl6-SD／Dif、Tmsv—basal—SD／Dif、Tmsv—mid—SD／Dif、Tmsv-apical-SD／Dif逐渐降低，差异均具有统计学意义（P〈0．05）。②SDI越高，I，VEF越低；SDI下降，LVEF升高；SDI与LVEF具有良好的负相关性（人院时、4周末、8周末r分别为-0．758、-0．831、-0．889，均Pd0．05）。结论I．VABS患者入院时存在严重的左室收缩不同步，4周末、8周末收缩不同步指数逐渐下降，SDI与LVEF呈负相关。Objective To evaluate the left ventricular systolic dyssynchrony in patients with left ventricular apical ballooning syndrome （ LVABS ） quantitatively by real-time three-dimensional echocardiography（RT-3DE） and its correlation with left ventricular ejection fraction（I.VEF）. Methods 7 patients with LVABS were enrolled in this study. The images of left ventricle in full volume mode were obtained by RT3DE in the different time （just after admission, 4 weeks and 8 weeks）. Post-processing software of 4D LV Volume Tom Tec was used for calculation of EF and 16-segmental time-volume curves was obtained. The time to the point with minimal systolic volume（Tmsv） of each segment was calculated and by which the following indexes of systolic dyssynchrony were derived： Tmsvl6-SD/Dif, Tmsv basal- SI）/Dif,Tmsv- mid-SD/Dif and Tmsv apical-SD/Dif. The correlation between systolic dyssynchrony index （SDI） and LVEF was analysed. Results （1） The Tmsvl6 SD/Dif, Tmsv-basal-SD/Dif, Tmsv mid-SD/Dif and Tmsv-apical-SD/Dif of left ventricle in the patients of 4 weeks and 8 weeks were smaller than those of the patients iust after admission. There were significant differences among them（all P 〈.0.05）. （2）The more SDI increased,the more LVEF decreased,and vice versa. SDI was negatively associated with LVEF in the different time of admission （ just after admission： r = - 0. 758; 4 weeks： r = - 0. 831; 8 weeks： r = - 0. 889;a1l P 〈0.05）. Conclusions Left ventricular systolic dyssynchrony of severe degree is observed in patients with LVABS just after admission. But the condition of dyssynchrony has been improved gradually after 4 weeks and 8 weeks. SDI is negatively correlated with LVEF.

关 键 词：超声心动描记术 实时三维 心肌疾病 心室功能 左 左室心尖球形综合征 

分 类 号：R542[医药卫生—心血管疾病]