三维超声心动图评估左心室收缩失同步在射血分数保留心衰中的应用研究  

Evaluation of Intraventricular Systolic Dys-Synchrony by Three-Dimensional Echocardiography in Patients with Ejection Fraction Preserved Heart Failure

作　　者：冒惠 崔磊[2] 周仲胤[3] Mao Hui;Cui Lei;Zhou Zhongyin(Department of Ultrasound,Rugao Hospital of Traditional Chinese Medicine,Rugao,Jiangsu 226500,China;Department of Imaging,Nantong First People'Hospital,Nantong,Jiangsu 226000,China;Department of Cardiac Ultrasound,Nantong First People'Hospital,Nantong,Jiangsu 226000,China)

机构地区：[1]如皋市中医院超声科,江苏省如皋市226500 [2]南通市第一人民医院影像科,江苏省南通市226000 [3]南通市第一人民医院心超室,江苏省南通市226000

出　　处：《中国超声医学杂志》2024年第3期293-296,共4页Chinese Journal of Ultrasound in Medicine

基　　金：南通市市级科技计划(指导性)项目(No.MSZ18199)。

摘　　要：目的 探讨实时三维超声心动图(RT-3DE)对射血分数保留心衰(HFpEF)患者左心室收缩失同步(ISD)的评估价值。方法 选取133例慢性心衰患者,根据2016年欧洲心脏病学会的定义分为射血分数保留心衰(HFpEF)组(75例)和射血分数减低心衰(HFrEF)组(58例),选取61例健康体检者为对照组。在患者入院或诊断后收集常规超声心动图及RT-3DE参数。结果 各组间左心室大小、LVEF、左心室壁厚度、E/e′、三维左心室收缩不同步指数(3D-SDI)差异均有统计学意义(P<0.05),与对照组比较,HFpEF组左心室壁厚度、E/e′、3D-SDI差异有统计学意义(P<0.05),HFpEF组3D-SDI与三维左室射血分数(3D-LVEF)呈负相关(r=-0.354、-0.342、-0.331、-0.333、-0.315、-0.263,P<0.05)。二元Logistic回归分析显示,Tmsv16-SD%、E/e′、室间隔厚度是HFpEF发生的独立危险因素。结论 RT-3DE对HFpEF患者ISD的评估具有独特的优势,可以为HFpEF患者的诊断提供更加全面和准确的信息,有望成为HFpEF中重要的辅助检查手段。Objective To evaluate the value of real-time three-dimensional echocardiography(RT-3DE) in the evaluation of left ventricular intraventricular systolic dys-synchrony(ISD) in patients with heart failure with ejection fraction preserved(HFpEF).Methods According to the definition of heart failure published by European College of Cardiology in 2016,133 patients with chronic heart failure were divided into HFpEF group(n=75) and heart failure with reduced ejection fraction(HFrEF) group(n=58).A total of 61 healthy subjects were selected as the control group.Routine echocardiography and RT-3DE parameters were collected after hospital admission or upon diagnosis.Results There were significant differences in left ventricular size,left ventricular ejection fraction(LVEF),left ventricular wall thickness,E/e′ and three-dimensional left ventricular systolic dys-synchrony index(3D-SDI) among the three groups.Compared with the control group,there were significant differences in left ventricular wall thickness,E/e′ and 3D-SDI in the HFpEF group.In HFpEF group,3D-SDI was negatively correlated with three-dimensional left ventricular ejection fraction(3D-LVEF)(r=0.354,-0.342,-0.331,-0.333,-0.315,-0.263,P<0.05).Binary Logistic regression analysis showed that Tmsv16-SD%,E/e′ and interventricular septal thickness were independent risk factors for HFpEF.Conclusions RT-3DE has unique advantages in the evaluation of ISD in patients with HFpEF,which can provide more comprehensive and accurate information for the diagnosis of HFpEF patients,and is expected to become an important auxiliary examination method in HFpEF.

关 键 词：实时三维超声心动图 射血分数保留型心力衰竭 同步性 

分 类 号：R540.45[医药卫生—心血管疾病] R541.6[医药卫生—内科学]