声学定量技术评价充血性心衰患者左室收缩、舒张功能的改变

目的:采用声学定量技术观察充血性心力衰竭(心衰)患者治疗前后左室收缩、舒张功能的改变。方法:34例心衰患者为患者组(NYHA心功能III~IV级),给予常规抗心衰药物治疗。采用声学定量技术测量左室舒张末容积(EDV)、左室收缩末容积(ESV)、左室射血分数(EF)、左室峰值排空率(PER)、左室峰值快速充盈率(PRFR)、左室峰值心房充盈率(PAFR)、左室峰值快速充盈率与左室峰值心房充盈率之比(PRFR?蛐PAFR)。并以34例正常人为对照组。结果:患者组治疗前与正常组比较EDV、ESV、PAFR和PRFR明显增大(P<0.001、P<0.001、P<0.001和P<0.05),EF和PER明显减低(P<0.001和P<0.05),而PRFR?蛐PAFR无明显差异(P>0.05)。患者组治疗后与治疗前比较ESV、EDV和PAFR明显减小(P值均<0.001),EF和PER明显提高(P值均<0.001),PRFR和PRFR?蛐PAFR变化不大(P值均>0.05)。结论:声学定量技术有助于评价心衰患者的左室收缩功能,对于晚期心衰患者左室舒张功能的评价有一定局限性。

Evaluating left ventricular function in congestive heart failure before and after treatment by acoustic quantification

Objective: To evaluate left ventricular systolic and diastolic function before and after treatment by acoustic quantification(AQ). Methods: Thirty-four normal subjects were selected as control group, 34 consecutive patients with a clinical diagnosis of congestive heart failure were studied by echocardiography. Left ventricle end diastolic volume(EDV), end systolic volume(ESV), ejection fraction(EF), peak ejection rate(PER), peak rapid filling rate(PRFR) and peak atrium filling rate(PAFR) were also measured, PRFR PAFR were calculated. Results: Compared with healthy controls, EDV, ESV, PRFR and PAFR had significantly increased(P<0.001, P<0.001, P<0.001 and P<0.05 respectively), EF and PER significantly decreased(P<0.001 and P<0.05 respectively), PRFR PAFR had no significant differences. ESV, EDV and PAFR had significantly decreased(P<0.001), EF and PER significantly increased(P<0.001), PRFR and PRFR PAFR had no significant differences after treatment(P>0.05). Conclusions: AQ is helpful to evaluate left ventricular systolic function, while evaluating left ventricular diastolic function of heart failure patients in late phase, AQ is limited.