实时三维超声技术评价左心室心肌致密化不全患者左心房射血功能

目的应用实时三维超声技术评价左心室心肌致密化不全（LVNC）患者左心房功能，并探讨其在LVNC诊断中的应用价值。 方法选择2015年2月至2016年8月于中国医科大学附属盛京医院就诊的LVNC患者20例，同时选择同期该院体检的20名年龄相匹配的健康志愿者作为健康对照组。常规超声测量室间隔厚度（IVS）、左心室舒张末期内径（LVEDD）。自动计算得出左心室射血分数（LVEF）。测量组织多普勒二尖瓣口E波峰值（E）、二尖瓣口A波峰值（A），并计算E/A比值。采集左心心尖四腔切面full-volume图像，软件自动输出左心房最大容积（LAV_max）及左心房射血分数（LAEF），并计算LAV_max/体表面积比值。采用独立样本t检验比较LVNC组患者与健康对照组受检者IVS、LVEDD、LVEF、E/A、LAEF、LAV_max/体表面积。 结果LVNC组患者与健康对照组受检者年龄、IVS、LVEDD、LVEF、E/A差异均无统计学意义。LVNC组患者LAEF、LAV_max/体表面积均高于健康对照组受检者［（62.57±7.36）% vs （50.12±7.00）%，（22.80±8.52）ml/m² vs （18.00±4.99）ml/m²］，且差异均有统计学意义（t=5.3，P<0.01；t=2.1，P<0.05）。 结论LVNC患者左心室射血功能正常条件下，左心房射血功能已有明显提高。应用实时三维超声技术可以对LVNC患者心脏功能进行评估。

Evaluation of left atrial ejection function in patients of noncompaction cardiomyopathy by real-time three-dimensional echocardiography

ObjectiveTo assess left atrial ejection function by left atrium ejection fraction (LAEF) in left ventricular noncompaction (LVNC) patients by real-time three-dimensional echocardiography (RT3DE) and discuss its value in LVNC diagnosis. MethodsThe study comprised 20 patients with the diagnosis of LVNC including 3 cases in the group of 3-16 years old, 8 cases in the group of 17-35 years old, and 9 cases in the group of 36-55 years old. Twenty healthy age-matched people were chosen as controls. All patients underwent conventional two-dimensional echocardiography and RT3DE with full-volume image. ResultsThe measures of interventricular septum thickness, left ventricularend-diastolic diameters and left ventricular ejection force in the two-dimensional echcardiography showed no differences. The average LAEF of LVNC grroup was higher than that of the control group (t=5.3, P<0.01). The average LAEF of LVNC group was (62.57±7.36)% while that of the control group was (50.12±7.00)%. ConclusionsThe result showed obvious difference. It showed that the left atrial ejection function had increased significantly even though the left ventricular systolic function was normal. RT3DE can assess the heart function of LVNC patients.