实时三维超声心动图评价冠心病患者左心室重构指数与收缩功能的研究

目的 应用实时三维超声心动图(RT-3DE)评价冠心病患者左心室重构指数(LVRI)、射血分数(EF)及其相关性.方法 根据冠状动脉造影结果分为左旋支或(和)右冠支病变组(LCX/RCA组)24例、单纯左前降支病变组(LAD组)21例、包含LAD病变的双支或多支病变组(多支组)27例及正常对照组22例,应用RT-3DE采集上述研究对象的左心室全容积三维图像,在分析软件上测量左室舒张末期容积(EDV)、左室舒张末期心外膜容积(EDVepi)、EF,计算左室质量、LVRI;比较组间LVRI、EF差异及组内LVRI与EF的相关性.结果 LVRI与EF在正常对照组、LCA/RCA组、LAD组、多支组呈显著性递减,差异有统计学意义(P＜0.05或P＜0.01);相关性分别为r=0.10(P＞0.05),0.86(P＜0.01),0.83(P＜0.01),0.77(P＜0.01).结论 LVRI能评价不同冠心病患者左室重构并能反映其左室收缩功能,可作为评价左室重构的新指标应用于临床.

Real-time three-dimensional echocardiographic assessment of left ventricular remodeling index and systolic function in patients with coronary artery disease

Objective To explore left ventricular remodeling index(LVRI),systolic function and their correlation by real-time three-dimensional echocardiography(RT-3DE)in patients with coronary artery disease(CAD).Methods According to coronary artery angiography,one main vessel stenosis no less than 50% was defined as positive standard,RT-3DE data of 24 patients with left circumflex coronary artery or/and right coronary artery stenosis(LCA/RCA group),21 patients with left anterior descending coronary artery stenosis(LAD group),27 patients with double or triplex coronary arteries stenosis which must included LAD(vessels group)and 22 normal controls(NC group)were acquired.Left ventricular end-diastolic volume(EDV),left ventricular end-diastolic epicardial volume(EDVepi),left ventricular ejection fraction(EF)were automatically measured by RT-3DE analysis software;left ventricular mass1.05×(EDVepi-EDV)],LVRI(left ventricular mass/EDV)were calculated.The inter-group differences of LVRI,EF and intra-group correlations between LVRI and EF were analyzed.Results LVRI and EF significantly decreased in order(P＜0.05 or P＜0.01);and their correlation coefficents were r=0.10(P＞0.05),0.86(P＜0.01),0.83(P＜0.01)and 0.77(P＜0.01)in NC group,LCA/RCA group,LAD group,vessels group,respectively.Conclusions LVRI measured by RT-3DE can assess left ventricular remodeling,and reflect left ventricular systolic function in different CAD,which can be as a new approach for evaluating left ventricular remodeling in clinic.