探讨实时三维超声心动图对预测慢性心力衰竭预后的价值  

Use of real-time three-dimensional echocardiography in predicting the prognosis of chronic heart failure

作　　者：苏秀秀[1] 金玮[1] 陈晔芬[1] 吴志俊[1] 陈燕佳 方跃华[1] 

机构地区：[1]上海交通大学医学院附属瑞金医院心脏科,200025

出　　处：《国际心血管病杂志》2017年第6期377-380,共4页International Journal of Cardiovascular Disease

摘　　要：目的:探究实时三维超声心动图(RT-3D)所获得的影像参数对慢性心力衰竭患者预后的预测价值。方法:选取162例慢性心力衰竭住院患者,入院时通过RT-3D全面采集超声影像。出院后平均随访12个月,观察终点定义为全因死亡和因心力衰竭加重再入院,以是否发生终点事件分为事件组(n=27例)和非事件组(n=135例),比较两组患者入院时左室应变参数以及RT-3D测定的左室形态学参数。结果:斑点追踪成像测定的左室收缩期整体纵向应变,事件组为(-6.25±2.31)%,无事件组为(-7.73±3.17)%;RT-3D测定的的同步性参数收缩前时间容积,事件组为(76.8±142.5)mL·%,无事件组为(32.8±85.0)mL·%,两组间差异均有统计学意义(P均<0.05)。结论:左室收缩期整体纵向应变减低、左室收缩前时间容积增加对心力衰竭预后不良具有一定的预测价值。Objective： To study the predictive value of real-time three-dimensional （RT-3D） echocardiography imaging parameters on the prognosis of patients with chronic heart failure （HF）. Methods：One hundred and sixty-two hospitalized patients with chronic HF were enrolled. Comprehensive ultrasonic imaging was collected by RT-3D full volume echocardiography. All patients were followed up for 12 months. The primary end point was defined as all-cause death and readmission due to worsening heart failure. According to the occurrence of primary end point, the patients were divided into event group（n = 27） and non-event group（n = 135）. The parameters of strain and morphology of left ventricle were analyzed and compared between the two groups. Results： The left ventricle systolic global longitudinal strain （GLS） measured by speckle tracking imaging was higher in event group than that in non-event group [（ -6. 25 ± 2. 31）% vs. （ - 7. 73 ± 3.17） %, P〈0. 05]. Pre-contraction time volume, a parameter of systolic synchrony, measured by RT-3D echocardiography was larger in event group than that in non-event group [（76. 8 ± 142. 5） mL·% vs. （32. 8 ± 85.0） mL·%, P〈0. 05]. Conclusion： In patients with chronic HF, the deteriorated GLS and increased pre-contraction time volume of left ventricle are predictors of adverse prognosis.

关 键 词：心力衰竭 实时三维超声心动图 斑点追踪成像 左室同步性 

分 类 号：R541.6[医药卫生—心血管疾病]