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.

Quantification of biventricular function and mass using real-time three-dimensional echocardiography in patients with hypertension

Objective Using real-time three-dimensional echocardiography (RT-3DE) to assess biventricular volumes, function and mass in patients with hypertension. Methods Biventricular and left atrial volumes, ejection fraction and left ventricular mass were determined by RT-3DE in 38 normal controls and 67 patients with hypertension which was divided into left ventricular hypertrophy (LVH) group and non-left ventricular hypertrophy (NLVH) group. Results The end-diastolic volume (EDV), end-systolic volume (ESV) of the left ventricle by RT-3DE 16-, 8-and 4-plane were greater than those obtained with RT-3DE 2-plane and two-dimensional echo (2DE), while ejection fraction(EF) was smaller (P<0.05). Compared with control group, EDV and ESV of left-and right-ventricular and left ventricular mass increased in LVH group and NLVH group(P<0.05). EF of left ventricle decreased in LVH group(P<0.05). LAVmax and LAVmin also increased in LVH group and NLVH group than those of controls, LAVmin/LAVmax only in LVH group(P<0.05). Conclusion The application of real-time three-dimensional echocardiography presents an important tool for the quantification of cardiac performance and left ventricular mass in the patients with hypertension.