三维体元模型超声重建法定量测量左室容积的实验研究

为了评价三维体元模型超声重建法定量左室容积的准确性，我们对７个左室模型和１７只离体猪心进行了研究，并与二维法和超声心动图自动边缘检测技术比较。结果显示；三维体元模型超声重建法，二维法和超声心动图自动边缘检测技术测量的左室模型窖容积与实测值均３接近，但相关系数以三维法最高。     

超声心动图三维重建定量左室壁膨展容积的实验研究

为评价超声心动图三维重建法测量室壁膨展容积的准确性。我们对１４个新鲜人离体以及和９个鹇猪离体心脏进行了研究。结果表明：三维重建的人左室腔容积与实测值高度相关（ｒ＝０．９９ ｐ＝０．００１）。三维重建的猪左室膨展模型的左室腔总容积、示膨展部容积、室壁膨展腔容积和室壁膨展腔容积／左室腔总容积的比值与实测值也高度相关（ｒ分别为０．９８、０．９８、０．８９和０．８９ ｐ均＝０．００１）。超声心动图三维重建     

实时三平面超声心动图测量左室室壁瘤的左室容积的实验研究

目的探讨实时三平面超声心动图(RT-3PE)测量离体猪心室壁瘤心模型的左室容积,分析此方法的可行性与准确性。方法应用10%福尔马林液固定17个模拟室壁瘤形成的离体猪心,将其浸入水槽中,用二维超声心动图的双平面Simpson法RT-3PE测量左室容积,其值分别与左室注水的真实容积进行对比研究。结果线性回归分析表明实时三平面成像所测左室容积与其真实容积相关性较好(r=0.92,P<0.01);方差分析表明两者间差异无统计学意义(P>0.05)。二维超声心动图双平面Simpson法所测左室容积与真实容积亦具有良好的相关性(r=0.82,P<0.01),但两者间有显著性差异(P<0.05)。Altman and Bland一致性分析显示RT-3PE所测容积与实测容积之间的一致性明显高于二维超声心动图。结论RT-3PE是一快速、准确测量左室室壁瘤左室容积的新方法。     

评价实时三维多平面成像超声心动图测量左室容积准确性的体外模型研究

目的应用体外模型,探讨实时三维多平面成像超声心动图测量左室容积的可行性及准确性。方法用橡胶袋制备不同大小左心室模型20个(其中模拟正常对称性左室模型12个,非对称性左室室壁瘤模型8个),分别应用实时三维超声心动图(RT3DE)多平面成像软件以及二维超声心动图(2DE)测量各模型的容积,其结果与相应的实测容积进行比较。结果12例正常左室模型与8例左室室壁瘤模型中,RT3DE测量的左室容积与实测容积之间呈高度相关,具有高度一致性,且无显著性差异;同样在12例正常左室模型与8例室壁瘤左室模型中,2DE测量的左室容积与实测容积之间相关性较好,两者之间一致性较差,且具有显著性差异。结论实时三维多平面成像超声心动图较之传统的二维超声心动图能够更为准确地测量左室容积,从而奠定了对左室功能进行可靠评价的基础。     

三维体元模型超声重建法定量测量左室壁心肌重量的实验研究

为了评价三维体元模型超声重建法定量测量左室壁心肌重量的准确性，我们对７个左室模型和１７只离体猪心进行研究，并与二维法进行比较。结果显示：三维体元模型超声重地和二维法测量左室模型的重量与实测值均非常接近，相关系数以三维法最高。三维法和二维法对变形的猪左室模型重量的测量结果与实测的差别无显著意义，误差率为１．２６％。     

实时三维超声心动图测量左室重量的实验研究

目的:探讨实时三维超声心动图(RT3DE)检测左室重量的可行性与准确性。方法:使用RT3DE系统采集10例利用双层橡胶水囊模拟的左室壁及10例离体犬心脏的左室“金字塔”型数据库,结合容积分析软件得出RT3DE左室重量值;同时用2DE的长度面积法测量左室重量;分别将RT3DE测量值、2DE测值与实际重量相比较。结果:RT3DE各平面法测量的左室重量与实际值均呈正相关(左室壁模型r=0.813~0.994,离体犬左室壁r=0.764~0.991),两者无显著性差异(P>0.05);2DE值与实际值亦呈正相关(左室壁模型r=0.628,离体犬左室壁r=0.514),两者有显著性差异(P<0.05)。RT3DE各平面法之间相比较,八平面与十六平面法之间没有显著性差异(P>0.05),而它们与两平面、四平面法之间有差异(P<0.05)。结论:实时三维超声心动图能准确测量左室重量,为评价左室功能提供了新的有力的工具。对于左室重量RT3DE测量,八平面法是准确与简便的最佳选择。     

超声心动图三维重建定量左室室壁膨展容积的实验研究

超声心动图三维重建定量左室室壁膨展容积的实验研究上海医科大学中山医院，上海市心血管病研究所张高星，浦寿月，沈学东，潘文明，吕力，舒先红，陈灏珠美国泛亚科技公司罗月秀为评价超声心动图三维重建法测量室壁膨展的容积的准确性。我们对１４颗新鲜人离体心脏和９颗...     

应用实时三维超声心动图技术评价高血压病患者心室质量和功能的研究

目的应用实时三维超声心动图技术评价高血压病患者心室质量、容积和功能改变.方法在38例正常人、36例高血压无左室肥厚（NLVH）患者和31例高血压伴左室肥厚（LVH）患者中进行了超声心动图检查.应用二维超声双平面Simpson法测量左室舒张末期容积（EDV）、收缩末期容积（ESV）和射血分数（EF）,实时三维超声测量左室质量（LVM）及左室质量指数（LVMI）, 左、右心室容积、左房最大容积（Vmax）、最小容积（Vmin）及Vmin/Vmax.结果应用实时三维超声心动图16平面、8平面法、4平面法与2平面法、二维超声双平面Simpson法测量的左室EDV、ESV、EF各组测值之间差异有统计学意义.应用RT-3DE 16平面法测量的LVM、LVMI低于M型超声测值.与对照组比较,高血压NLVH组、LVH组三维超声测量的左室EDV、ESV均显著增高,高血压LVH组左室EF减低;高血压LVH组、NLVH组右室EDV、ESV均较对照组增大,两组左房Vmax、Vmin增加,LVH组Vmax/Vmax增加.结论实时三维超声技术能够定量评价高血压病患者左、右心室及左房容积和功能,测量左心室质量.     

实时三维超声心动图评价轻度高血压病患者左心功能

目的 应用实时三维超声心动图技术评价轻度高血压病患者左心功能.方法 分别对50例正常人和81例高血压患者进行二维超声心动图及三维超声心动图检查.测量左室舒张末期容积、收缩末期容积和射血分数,左房收缩末容积.结果 二维超声测量的左室舒张末容积、收缩末容积、射血分数高血压病患者与正常组间无统计学差异.实时三维超声心动图测值与正常组比较,高血压组左室收缩末容积减低,左室射血分数升高.二维超声心动图测量左房前后径高血压组与正常组无统计学差异.实时三维超声心动图测量左房收缩末容积高血压组较正常组增加.结论 实时三维超声心动图技术较二维超声心动图更能够早期发现高血压病患者左心功能及结构的变化.     

超声心动图测定左室心肌重量的实验研究

为评价二维超声心动图定量左室心肌重量的准确性。我们取１０个离体新鲜猪心，去除左、右心房和右心室，放入水槽，用Ｈｅｗｌｅｔｔ ｐａｃｋａｒｄ Ｓｏｎｏｓ１０００多功能超声诊断仪和２．５ＭＨｚ探头显示左室长轴切面，录像记录在磁带上。事后用仪器内配置的计算机软片，以Ｓｉｍｐｓｏｎ’ｓ法计算左室总容积和心腔容积，两者之差即为左室壁心肌容积。左室心肌的重量为左室壁心肌容积和心肌的比重（１．０５）之乘积。结果     

Three-dimensional reconstruction of echocardiographic images using the rotation method

We describe a method for three-dimensional reconstruction of real time two-dimensional echocardiographic images using a rotation method. Seven tissue specimens were studied in a water bath and two-dimensional images were recorded by rotating the transducer every 30°, from 0 to 180°. Angular reconstruction of areas was obtained at different axial locations and volumes calculated by a Sigma 9 computer using axial summation without geometric assumptions. Using spatial coordinate data, three-dimensional perspective images could be plotted by the computer in any desired view. The volumes obtained by this method (range 90–231 ml) corresponded closely (R = 0.96) with volumes measured directly by water displacement (range 95–200 ml). Two patients were also studied with this technique by placing the transducer at the cardiac apex to record two-dimensional left ventricular and diastolic and end systolic images. Three-dimensional reconstructed volumes closely correlated with those obtained by left ventricular angiography. Ejection fraction in one patient was 52% by three-dimensional reconstruction, 47% by angiocardiography. In the other patient, the ejection fraction was 76% by three-dimensional imaging, 69% by angiocardiography. This preliminary study demonstrates the feasibility and simplicity of three-dimensional reconstruction using the rotation method.     

超声三维斑点追踪成像技术评价慢性心力衰竭患者左心室整体应变的初步研究

目的应用三维斑点追踪成像技术初步评价慢性心力衰竭(CHF)患者左心室整体径向、纵向、环向收缩期峰值应变特征,并探讨其价值及可行性。方法 CHF患者29例(CHF组)及正常志愿者34例(正常组),采集标准心尖四腔切面左心室全容积图像并存储,应用3-Dtrace软件进行在线分析,自动计算左心室舒张末期容积(LVEDV)、左心室收缩末期容积(LVESV)、左心室射血分数(LVEF)、左心室整体纵向收缩期峰值应变(LVGLS)、左心室整体环向收缩期峰值应变(LVGCS)及左心室整体径向收缩期峰值(LVGRS),并比较CHF组与正常组之间的各应变指标变化情况及与LVEF的相关性。结果 CHF患者左心室LVEF、LVGLS、LVGCS、LVGRS较正常组减低(P0.05)。LVGLS、LVGCS、LVGRS与LVEF相关系数分别为0.846、0.871和0.828(P0.01)。结论 CHF患者左心室整体功能明显减低,三维斑点追踪技术可无创、客观地评价左心室整体收缩功能,为评价左心室功能提供一个新的手段。     

实时全容积三维超声心动图初步评价正常胎儿心室容积和心室收缩功能

目的 探讨实时三维超声在研究正常胎儿心室发育和心室收缩功能方面的价值.方法 回顾分析54例正常胎儿全容积三维数据,通过后处理软件获得心室容积参数,包括舒张末期容积(EDV)、收缩末期容积(ESV)和搏出量(SV)及心室收缩功能参数射血分数(EF),分析胎儿心室容积发育与孕周的关系,比较左右心室容积和收缩功能的差异.结果 胎儿左右心室容积参数EDV、ESV、SV与孕周间均有线性相关关系,随孕周增长而增加,而收缩功能参数EF与孕周之间无明显线性关系,随孕周增长无明显变化;容积参数EDV、ESV左右心室之间差异无明显统计学意义,而SV、EF左右心室间差异有统计学意义(P＜0.05).结论 实时三维超声对胎儿心内膜清晰成像时能够获得心室腔容积,进而评价心脏收缩功能,有助于进一步研究胎儿心脏容积发育和收缩功能变化.     

实时三维超声心动图定量冠心病、扩张型心肌病心房和心室容积及功能的研究

目的应用实时三维超声心动图(RT-3DE)定量评价冠心病、扩张型心肌病患者左心室、左心房、右心室和右心房容积及收缩功能。方法在24例正常人、16例扩张性心肌病和27例心肌梗死患者中,应用实时三维超声心动图获取各房室全容积三维图像,分别应用2、4、8平面方法测量各房室收缩末期容积(ESV)、舒张末期容积(EDV)和射血分数(EF),并与二维超声心动图(2DE)Simpson法和声学定量(AQ)技术测值比较。结果在扩张性心肌病和心肌梗死患者中,2DE、AQ技术和RT-3DE2平面法测量的左、右心房和左、右心室ESV、EDV明显低于RT-3DE4平面法、8平面法测值(P<0.05);各种方法检测的EF值差异无统计学意义(P>0.05)。2DE、AQ技术和RT-3DE检测结果均显示扩张性心肌病、心肌梗死患者各房室ESV、EDV均明显大于正常组(P<0.05),EF明显低于正常组(P<0.05)。结论应用实时三维超声心动图能显示心腔立体结构,测量各心腔容积,评价心脏功能。     

二维超声图的左室壁边缘检测及三维重建

作者通过对不同角度的左心室心尖部沿左室长轴的二维超声图进行边缘检测.将所得不同截面的左心室边缘点按其空间位置重建左心室三维图,从而得出有关的心功能指标。采用人心标本做左心室三维重建实验,得到了左心室的线框图和灰度图显示,由左心室三维图计算出的左心室容积与测量值基本相符。     

Augmented expression of atrial natriuretic polypeptide gene in ventricle of human failing heart.

To elucidate the expression of the atrial natriuretic polypeptide (ANP) gene in the ventricle of the human failing heart, we have measured ANP and ANP messenger RNA (ANPmRNA) levels in left ventricular aneurysm obtained at operation, biopsy specimens of left ventricles from dilated cardiomyopathy (DCM) and autopsy samples of old myocardial infarction (OMI) and DCM hearts, and compared the levels with those in the normal ventricle. The ANP level (mean +/- SE) was 17.5 +/- 6.9 ng/g in the normal ventricle, and increased to 660.3 +/- 122.2 ng/g in the left ventricular aneurysm tissues and to 3,138.6 +/- 1,642.1 ng/g in the biopsy specimens of the DCM ventricle. These levels were approximately 40 and 200 times higher than in the normal ventricle. The increase of ANP levels was observed in both infarcted and noninfarcted regions of the OMI heart, and in the entire ventricle of the DCM heart. A significant positive correlation was found between the ANP level in aneurysm tissues and pulmonary capillary wedge pressure (r = 0.85). The ANPmRNA level in the left ventricular aneurysm showed about a 10-fold increase compared with that in the normal heart and reached 23% of that in the atrium of the same heart. A similar increase in the ANPmRNA level was observed in the entire ventricle of DCM. These data clearly indicate that the expression of the ANP gene in the ventricle is augmented in the failing heart in accordance with the severity of heart failure. In the atrium of the failing heart, ANP and ANPmRNA levels were only two times higher than those in the normal atrium. Thus, the augmentation in the expression of the ANP gene was more prominent in the ventricle than in the atrium. Taking tissue weight into account, the total content of ANPmRNA in the ventricle of the failing heart is much the same as that in the normal atrium. The ratio of the ANP level to the ANPmRNA level in the ventricle is much smaller than that in the atrium. These results suggest more rapid secretion of ANP after synthesis in the ventricle. These findings demonstrate that the expression of the ANP gene is augmented in the human ventricle of the failing heart and suggest that the ventricle becomes a substantial source of circulating ANP in congestive heart failure.     

Clinical demonstration of vibration-induced depression of left ventricular function

In experimental studies, minute sinusoidal vibration has been reported to induce functional depression of the left ventricle and to be an index for evaluation of myocardial crossbridge kinetics. Therefore, to examine whether or not this vibration-induced functional depression could also be observed in the human ventricle, motion of the left ventricular (LV) wall or LV pressure was measured by echocardiography (n = 16) or by left heart catheterization (n = 4), in which 100 Hz, 2.07 mm-amplitude sinusoidal vibration was applied to the subject's precordium. In the echocardiographic study, left ventricular wall shortening did not change by vibration in nine healthy volunteers, but was depressed in two patients with aortic regurgitation (AR) and in one patient with ischemic heart disease (IHD). In measurement of LV pressure, the decrease in LV systolic pressure caused by vibration was obviously observed in two patients (AR and IHD) but was not observed in two patients with hypertrophic cardiomyopathy. These results suggest that we might be able to extend previously proposed experimental idea on early detection of the abnormality in myocardial crossbridge kinetics to the clinical setting.     

超声心动图评价心脏再同步化治疗疗效

目的探讨超声心动图在慢性充血性心力衰竭患者心脏再同步化治疗疗效评价中的应用价值。方法 27例接受心脏再同步化治疗的慢性充血性心力衰竭患者,分别于术前及术后6个月应用超声心动图测量左心室大小、左心室容积、左心室射血分数、二尖瓣反流面积、房室间、心室间及左心室内同步性。结果术后6个月患者左心室收缩末内径、左心室舒张末内径、左心室收缩末容积、左心室舒张末容积小于术前（P〈0.05或P〈0.01）,房室间、心室间、左心室内收缩同步性改善（P〈0.05或P〈0.01）。结论超声心动图可通过多项参数综合评价心脏再同步化治疗的效果。     

Application of free-hand three-dimensional echocardiography in the evaluation of fetal cardiac ejection fraction: a preliminary study.

OBJECTIVE: To investigate the feasibility of using free-hand three-dimensional (3D) echocardiography to evaluate fetal cardiac function. METHODS: 3D cardiac data were collected during screening examinations for 37 normal fetuses with gestational ages of between 16 and 26 weeks. Processing of the 3D volumes included separation of the end-diastolic and end-systolic slices, segmentation of right and left ventricles, measurement of end-diastolic and end-systolic volumes, and calculation of the ejection fraction (EF) for each ventricle. In 21 fetuses at 21-24 weeks, right and left ventricle volumes and EF were compared. RESULTS: Twenty-five cases were appropriate for final statistical analysis. The volume of the ventricles increased with gestational age and estimated fetal weight. There was no significant trend in the difference between the volumes and EF of the right and left ventricles in the 21-24-week subgroup. The mean right and left ventricular EF were 54 +/- 11.2% and 57.5 +/- 14.6%, respectively. The mean combined EF of ventricles during gestation was 55.1 +/- 10.7% and seemed to remain constant during the gestational ages studied. CONCLUSIONS: 3D echocardiography can provide estimates of ventricular volume and function and may in future be used for evaluation of fetuses with congenital heart disease and cardiac dysfunction.