单心动周期全容积成像对扩张性心肌病左室收缩功能和收缩同步性的评价

目的应用单心动周期实时四维超声心动图(sRT-4DE)评价扩张性心肌病(DCM)左室整体节段舒缩功能及室壁运动同步性,探讨左室收缩功能对左室室壁运动同步性的影响。方法 DCM组35例和对照组35例均行sRT-4DE检查,通过左室分析软件获得整体及节段容积-时间曲线、左室整体及节段收缩功能参数、左室收缩同步性参数。结果与对照组比较,DCM组左室收缩末期容积和舒张末期容积增大(P﹤0.01),左室射血分数减小(P﹤0.001),DCM组左室16节段的收缩不同步化指数、最大时间差及收缩末球形指数增大(P﹤0.05);且DCM组左室16节段收缩不同步化指数、最大时间差及收缩末球形指数均与LVEF呈负相关,相关系数分别为-0.743、-0.654、-0.625(均P0.01)。结论 sRT-4DE能够准确评价扩张性心肌病患者左室收缩同步性和收缩功能,左室整体及节段收缩减退可影响左室室壁运动的同步性。

Evaluation of left ventricular systolic synchrony and its systolic function in patients with dilated cardiomyopathy using single beat real-time four dimensional echocardiography

Objective To evaluate the left ventricular systolic synchrony, systolic function and the relation between left ventricular systolic synchrony and its systolic function in patients with dilated cardiomyopathy using single beat real-time four dimensional echocardiography（sRT-4DE ）.Methods Thirty-five healthy subjects （control group ） and 35 patients with dilated cardiomyopathy （DCM group） were enrolled and analyzed by sRT-4DE.Full-volume imaging was performed and the data were analyzed by left ventricular analysis software. A series of global and regional left ventrieular volume curves were plotted.The parameters of left ventficular systolic function and synchrony in entire and regional cardiac ventricle were collected.Results In DCM group, the ESV and EDV were larger and the LVEF was lower than that of the control group（P 〈 0.01 ）.The systolic synchrony parameters were significant larger in DCM group （P 〈 0.001 ）.The SDLTmsv16-Dif and ESSI in the DCM group were negatire related with LVEF, r were -0.743, -0.654, -0.625, respectively （P 〈 0.01 ）. Conclusion sRT-4DE can evaluate left ventrieular systolic synchrony and systolic function in patients with dilated cardiomyopathy accurately.The entire or local left ventrieular systolic function slowing down can bring negative effect to its systolic synchrony.