冠状动脉病变支数对三维超声心动图左室收缩功能测量准确性影响的研究

为探讨冠状动脉病变支数对三维超声心动图（３ＤＥ）左室收缩功能测量结果的影响，应用多平面经食管３ＤＥ技术测量了冠状动脉单支血管病变患者９例（Ａ组）及多支血管病变患者１１例（Ｂ组）的左室舒张末期容量（ＥＤＶ）、收缩末期容量（ＥＳＶ）、心搏量（ＳＶ）及射血分数（ＥＦ），并与二维超声心动图（２ＤＥ）及左室造影（ＬＶＡ）的测值进行了对比，结果显示：１．Ａ、Ｂ两组患者中，２ＤＥ测量的ＥＤＶ、ＥＳＶ、ＳＶ及ＥＦ与ＬＶＡ相应测值仅呈中度相关，３ＤＥ则呈高度相关，且３ＤＥ所测ＥＤＶ、ＥＳＶ对左室造影结果的低估程度仅为２ＤＥ方法的一半；２．Ａ、Ｂ两组患者中，２ＤＥ所测ＥＦ均高于左室造影结果（Ｐ＜０．０１），３ＤＥ所测ＥＦ则与左室造影测值无显著差异（Ｐ＞０．０５）。３．用２ＤＥ、３ＤＥ及ＬＶＡ３种方法测量Ｂ组患者的ＥＦ较Ａ组患者明显降低（Ｐ＞０．０５），而ＥＤＶ则显著增加（Ｐ＜０．０５）。表明冠状动脉病变支数对２ＤＥ和３ＤＥ心功能测量的准确性有一定的影响；经食管３ＤＥ测量冠心病患者左室功能的准确性优于２ＤＥ方法，为左室收缩功能的定量评价提供了简便可行的新途径

QUANTIFICATION OF THE LEFT VENTRICULAR SYSTOLIC FUNCTION IN PATIENTS WITH CORONARYARTERY DISEASE BY TWO DIMENSIONAL AND MULTIPLANE TRANSESOPHAGEAL THREE DIMENSIONAL ECHOCARDIOGRAPHY:IMPACT OF THE NUMBER OF CORONARY ARTERY BRANCH STENOSIS

To evaluate the impact of the numer of coronary artery branch stenosis on quantification of the left ventricular systolic function by two dimensional(2DE)and multiplane transesophageal three dimensional echocardiography(3DE),9 patients with stenosis of 1 branch of coronary artery(group A)and 11 patients with stenoses of 2 or 3 branches of coronary artery (group B)were examined with 2DE,3DE and left heart catheterization(LVA) within 24 hours.The results showed that:1.In group A and group B,there were high correlations of EDV ESV,SV and EF measured by 3DE and LVA;whereas there were only moderate correlations measured by 2DE and LVA;2.In group A and B,there were no sigificant differences between EF measured by 3DE and LVA,but EF measured by 2DE were overestimated( P <0.01).In conclusion,the number of coronary artery branch stenosis influenced the accuracy of both 3DE and 2DE,and the 3DE provides a highly feasible approach to the measurement of the left ventricular volume and ejection fraction,and is superior to 2DE in quantitating left ventricular systolic function in patients with coronary artery disease.