实时三维超声心动图容积时间曲线评价左心室整体收缩和舒张功能

目的 应用实时三维超声心动图(RT-3DE)容积-时间曲线(VTC)定量评价左心室整体收缩和舒张功能.方法 98例研究对象分为4组:A组,正常人28例;B组,高血压病患者24例;C组,冠心病患者24例;D组,扩张性心肌病22例.对所有研究对象进行RT-3DE检查,采集全容积三维图像,应用Qlab分析软件对三维数据库进行分析,得到左室整体和17节段容积时间曲线,测量舒张末容积(EDV)、收缩末容积(ESV)和左室射血分数(EF),并计算峰值射血率(PER)、舒张早期峰值充盈率(PFR)、PER/EDV、PFR/EDV.结果 B、C、D组EDV、ESV显著大于A组,PFR/EDV显著小于A组(均P＜0.05);C、D组EF、PER/EDV显著小于A组(均P＜0.05).PER/EDV与EF有较好的相关性(r=0.694,P＜0.05).A组17节段VTC排列有序,收缩期与舒张早期形态对称;B、C、D 3组VTC形态与A组有明显不同,收缩期与舒张早期不对称.结论 实时三维超声心动图容积时间曲线可客观评价左室收缩和舒张功能,PER/EDV、PFR/EDV可作为定量评价左室收缩功能和舒张功能的有效指标.

Assessment of left ventricular global systolic and diastolic function using volume-time curves by real-time three-dimensional echocardiography

Objective To quantitatively assess left ventricular global systolic and diastolic function using volume-time curves (VTC) by real-time three-dimensional echoeardiography(RT-3DE).Methods Ninty-eight subjects were divided into four groups.Group A consisted of twenty-eight normal subject,group B included twenty-four patients with hypertensive(HTN), group C consisted of twenty-four patients with coronary artery disease(CAD) and group D of twenty-two patients having dilated cordiomyopathy (DCM).Participants were selected undergoing full volume RT-3DE.The global and 17-segmental VTCs were obtained by the off-line Qlab software.The end-diastolic volume(EDV), end-systolic volume(ESV) and ejection fraction(EF) were derived from VTCs.The peak ejection rate(PER),peak early filling rate (PFR),PER/EDV and PFR/EDV were calculted.Results EDV and ESV of group B,C and D was significantly larger than that of group A(all P < 0.05), EF and PER/EDV of group C and D significantly lower than those of group A.There were close correlation between PER/EDV and EF ( r=0.694, P＜0.05).Comparison of VTC pattern of HTN,CAD and DCM with that of healthy participants revealed the loss of symmetry of systolic and diastolic pattern.Conclusions Generation of VTCs by RT3DE is a promising approach to evaluate left ventricular global systolic and diastolic function.PER/EDV and PFR/EDV may be potential parameters for assessing left ventricular global systolic and diastolic function.